Are hallucinations and paronia typical manifestations of parkinson's disease?

A 41 years old man with parkinson's disease is admitted to the hospital after experiencing severe night mares and periods of confusion. during lucid periods, he is very disturbed by these manifestations. at other times, he believes that his wife is participating in a conspiracy to harm him. what assessments and intervention should you consider? Are hallucinations and paronia typical manifestations of parkinson's disease? Might the client's manifestations be related to treatment or to some cause other than parkinson's disease?

It is important to realize that not every person with Parkinson's develops all signs or symptoms of the disease. For example, some people experience tremor as the primary symptom, while others may not have tremor but do have balance problems. Also, for some people the disease progresses quickly, and in others it does not. The following are descriptions of the most common primary symptoms of Parkinson's disease.

Tremor: In the early stages of the disease, about 70 percent of people experience a slight tremor in the hand or foot on one side of the body, or less commonly in the jaw or face. It appears as a "beating" or oscillating movement. Because the Parkinson's tremor usually appears when a person's muscles are relaxed, it is called "resting tremor." This means that the affected body part trembles when it is not doing work, and it usually subsides when a person begins an action. The tremor often spreads to the other side of the body as the disease progresses, but remains most apparent on the original side of occurrence.

Rigidity: Rigidity, also called increased muscle tone, means stiffness or inflexibility of the muscles. Muscles normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of motion. For example, a person who has rigidity may not be able to swing his or her arms when walking because the muscles are too tight. Rigidity can cause pain and cramping.

Bradykinesia: Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. People who have bradykinesia may walk with short, shuffling steps (this is called festination). Bradykinesia and rigidity can occur in the facial muscles, reducing a person's range of facial expressions and resulting in a "mask-like" appearance.

Postural instability or impaired balance and coordination: People with Parkinson's disease often experience instability when standing or impaired balance and coordination. These symptoms, combined with other symptoms such as bradykinesia, increase the probability of falling. People with balance problems may have difficulty making turns or abrupt movements. They may go through periods of "freezing," which is when a person feels stuck to the ground and finds it difficult to start walking. The slowness and incompleteness of movement can also affect speaking and swallowing.

Secondary symptoms of Parkinson's can be, for many, as troublesome as the primary movement symptoms of the disease. PDF receives many inquiries about secondary symptoms, and you can often find information about these problems in our educational materials and in our newsletter, the PDF News & Review. Secondary symptoms of Parkinson's include stooped posture, a tendency to lean forward or backward and speech problems, such as softness of voice or slurred speech caused by lack of muscle control. Non-motor symptoms, such as depression, also affect the life of a person with Parkinson's.

The following is a list of secondary symptoms of Parkinson's disease. Some of these symptoms have been discussed in PDF publications; please click on them to read more:

* Speech changes
* Loss of facial expression, or "masking"
* Micrographia (small, cramped handwriting)
* Difficulty swallowing
* Drooling (Q&A booklet, see question 28)
* Pain
* Dementia or confusion
* Sleep disturbances (Q&A booklet, see question 23)
* Constipation (Q&A booklet, see question 24)
* Skin problems
* Depression
* Fear or anxiety
* Memory difficulties and slowed thinking
* Sexual dysfunction
* Urinary problems (Q&A booklet, see question 25)
* Fatigue and aching
* Loss of energy
* Compulsive behavior
* Cramping (Q&A booklet, see question 27)