“Highly concentrated sources of oxygen promote rapid combustion and therefore are fire and explosion hazards in the presence of fuels. The fire that killed the Apollo 1 crew on a test launchpad spread so rapidly because the pure oxygen atmosphere was at normal atmospheric pressure instead of the one third pressure that would be used during an actual launch.”

LENNTECH.com http://www.lenntech.com/periodic/elements/o.htm#ixzz48HfY7per Water Treatment and Purification Company


Part II Raising awareness of both positives and negatives of oxygenation both medically and in our environment!

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Today covers the environment.

Take our environment, there’s a caustic substance common to our environment whose very presence turns iron into brittle rust, dramatically increases the risk of fire and explosion, and sometimes destroys the cells of the very organisms that depend on it for survival. This substance that makes up 21% of our atmosphere is Diatomic oxygen (O2), more widely know as just oxygen.

Oxygen picture————————————————                                               

The appearance of free oxygen in Earth’s atmosphere led to the Great Oxidation Event. This was triggered by cyanobacteria producing oxygen that was used by multi-cellular forms as early as 2.3 billion years ago. As evolutionary biologists from the Universities of Zurich and Gothenburg have shown, this multiple cellularity was linked to the rise in oxygen and thus played a significant role for life on Earth as it is today.

Cyanobacteria belong to Earth’s oldest organisms. They are still present today in oceans and waters and even in hot springs. By producing oxygen and evolving into multicellular forms, they played a key role in the emergence of organisms that breathe oxygen. This has, now, been demonstrated by a team of scientists under the supervision and instruction of evolutionary biologists from the University of Zurich. According to their studies, cyanobacteria developed multicellularity around one billion years earlier than eukaryotes — cells with one true nucleus. At almost the same time as multi-cellular cyanobacteria appeared, a process of oxygenation began in the oceans and in Earth’s atmosphere.

Multi-cellularity as early as 2.3 billion years ago

The scientists analyzed the phylogenies of living cyanobacteria and combined their findings with data from fossil records for cyanobacteria. According to the results recorded by Bettina Schirrmeister and her colleagues, multi-cellular cyanobacteria emerged much earlier than previously assumed. “Multi-cellularity developed relatively early in the history of cyanobacteria, more than 2.3 billion years ago,” Schirrmeister explains in her doctoral thesis, written at the University of Zurich.

Link between multicellularity and the Great Oxidation Event

According to the scientists, multicellularity developed shortly before the rise in levels of free oxygen in the oceans and in the atmosphere. This accumulation of free oxygen is referred to as the Great Oxidation Event, and is seen as the most significant climate event in Earth’s history. Based on their data, Schirrmeister and her doctoral supervisor Homayoun Bagheri believe that there is a link between the emergence of multi-cellularity and the event. According to Bagheri, multi-cellular life forms often have a more efficient metabolism than unicellular forms. The researchers are thus proposing the theory that the newly developed multi-cellularity of the cyanobacteria played a role in triggering the Great Oxidation Event.

Cyanobacteria occupied free niches

The increased production of oxygen set Earth’s original atmosphere off balance. Because oxygen was poisonous for large numbers of anaerobic organisms, many anaerobic types of bacteria were eliminated, opening up ecological ‘niches’. The researchers have determined the existence of many new types of multi-cellular cyanobacteria subsequent to the fundamental climatic event, and are deducing that these occupied the newly developed habitats. “Morphological changes in microorganisms such as bacteria were able to impact the environment fundamentally and to an extent scarcely imaginable,” concludes Schirrmeister.

Water oxygenation:

Water aeration is often required in water bodies that suffer from anoxic conditions, usually caused by adjacent human activities such as sewage discharges, agricultural run-off, or over-baiting a fishing lake. Aeration can be achieved through the infusion of air into the bottom of the lake, lagoon or pond or by surface agitation from a fountain or spray-like device to allow for oxygen exchange at the surface and the release of noxious gasses such as carbon dioxide, methane or hydrogen sulfide.

Dissolved oxygen (DO) is a major contributor to water quality. Not only do fish and other aquatic animals need it, but oxygen breathing aerobic bacteria decompose organic matter. When oxygen concentrations become low, anoxic conditions may develop which can decrease the ability of the water body to support life.

Surface aeration-Fountains aerate by pulling water from the surface of the water (usually the first 1–2 feet) and propelling it into the air. Some fountains incorporate the use of a draft tube, which extends deeper and is able to pull water from approximately six feet below the surface, so as to achieve more water circulation. Fountains are a popular method of surface aerators because of the aesthetic appearance that they offer. However, most fountains are unable to produce a large area of oxygenated water. Also, running electricity through the water to the fountain can be a safety hazard. Fountains help circulate water in oxygenation, of course to a limited degree.

Diffused aeration systems utilize bubbles to aerate as well as mix the water. Water displacement from the expulsion of bubbles can cause a mixing action to occur, and the contact between the water and the bubble will result in an oxygen transfer.

Coarse bubble aeration is a type of subsurface aeration wherein air is pumped from an on-shore air compressor, through a hose to a unit placed at the bottom of the water body. The unit expels coarse bubbles (more than 2mm in diameter), which release oxygen when they come into contact with the water, which also contributes to a mixing of the lake’s stratified layers.

Fine bubble aeration is an efficient way to transfer oxygen to a water body. A compressor on shore pumps air through a hose, which is connected to an underwater aeration unit.

Lake destratification Is using circulators that are commonly used to mix a pond or lake and thus reduce thermal stratification. Once circulated water reaches the surface, the air-water interface facilitates the transfer of oxygen to the lake water.

Oxygenation Barges During heavy rain, London’s sewage storm pipes overflow into the River Thames, sending dissolved oxygen levels plummeting and threatening the species it supports.[14] Two dedicated McTay Marine vessels, oxygenation barges Thames Bubbler and Thames Vitality are used to replenish oxygen levels, as part of an ongoing battle to clean up the river, which now supports 115 species of fish and hundreds more invertebrates, plants and birds.

The Smithsonian states the Earth has a surprising new player in the climate game: oxygen. Even though oxygen is not a heat-trapping greenhouse gas, its concentration in our atmosphere can affect how much sunlight reaches the ground, and new models suggest that effect has altered climate in the past. Greenhouse gases = too much of one thing. Human activity increases the amount of greenhouse gases in the atmosphere—mainly carbon dioxide from the burning of fossil fuels (coal, oil and natural gas). The extra greenhouse gas may be trapping much heat, abnormally raising Earth’s temperatures. Human activity increases the amount of greenhouse gases in the atmosphere—mainly carbon dioxide from the burning of fossil fuels (coal, oil, and natural gas). The extra greenhouse gas may be trapping too much heat, abnormally raising Earth’s temperatures. Human activity increases the amount of greenhouse gases in the atmosphere—mainly carbon dioxide from the burning of fossil fuels (coal, oil, and natural gas). The extra greenhouse gas may be trapping too much heat, abnormally raising Earth’s temperatures. Human activity increases the amount of greenhouse gases in the atmosphere—mainly carbon dioxide from the burning of fossil fuels (coal, oil, and natural gas). The extra greenhouse gas may be trapping too much heat, abnormally raising Earth’s temperatures. Human activity increases the amount of greenhouse gases in the atmosphere—mainly carbon dioxide from the burning of fossil fuels (coal, oil, and natural gas). The extra greenhouse gas may be trapping too much heat, abnormally raising Earth’s temperatures.

Oxygen currently makes up about 21 percent of the gases in the planet’s atmosphere, but that level hasn’t been steady over Earth’s history. For the first couple of billion years, there was the little oxygen in the atmosphere. Then, about 2.5 billion years ago, oxygen started getting added to the atmosphere by photosynthetic cyanobacteria. That waste product sparked the mass extinction known as the Great Oxygenation Event (explained above). But over time, new forms of life evolved that use or expel oxygen in respiration, and atmospheric oxygen levels continued to increase. “The production and burial of plant matter over long periods causes oxygen levels to rise,” explains Poulsen.

Levels can fall again when that trapped ancient organic matter becomes exposed on land, and elements such as iron react with oxygen from the atmosphere, a reaction called oxidative weathering. As a result of these processes, atmospheric oxygen levels have varied from a low of 10 percent to a high of 35 percent over the last 540 million years or so.

Poulsen and his colleagues were studying the climate and plants of the late Paleozoic, and during a meeting they started talking about whether oxygen levels might somehow have affected climate in the past. Studies have shown that atmospheric carbon dioxide has been the main climate driver through deep time, so most thought oxygen’s role has been negligible but we have to live which is breathing 02 and the ending result CO2 when we expire and surely need oil & natural gas to some extent even if we went on energy for all our electricity and cars. Remember everything has a beginning and an ending, with wear and tear done to it at the end.

Highly concentrated sources of oxygen promote rapid combustion and therefore are fire and explosion hazards in the presence of fuels. The fire that killed the Apollo 1 crew on a test launchpad spread so rapidly because the pure oxygen atmosphere was at normal atmospheric pressure instead of the one third pressure that would be used during an actual launch.

Oxygen regarding metals:

Rust is another name for iron oxide, which occurs when iron or an alloy that contains iron, like steel, is exposed to oxygen and moisture for a long period of time. Over time, the oxygen combines with the metal at an atomic level, forming a new compound called an oxide and weakening the bonds of the metal itself. Although some people refer to rust generally as “oxidation,” that term is much more general; although rust forms when iron undergoes oxidation, not all oxidation forms rust. Only iron or alloys that contain iron can rust, but other metals can corrode in similar ways.

The main catalyst for the rusting process is water. Iron or steel structures might appear to be solid, but water molecules can penetrate the microscopic pits and cracks in any exposed metal. The hydrogen atoms present in water molecules can combine with other elements to form acids, which will eventually cause more metal to be exposed.

If sodium is present, as is the case with saltwater, the corrosion is likely to occur more quickly. Meanwhile, the oxygen atoms combine with metallic atoms to form the destructive oxide compound. As the atoms combine, they weaken the metal, making the structure brittle and crumbly.

Some pieces of iron or steel are thick enough to maintain their integrity even if iron oxide forms on the surface. The thinner the metal, the better the chance that rusting will occur. Placing a steel wool pad in water and exposing it to air will cause rusting to begin almost immediately because the steel filaments are so thin. Eventually, the individual iron bonds will be destroyed, and the entire pad will disintegrate.

Rust formation cannot be stopped easily, but metals can be treated to resist the most damaging effects. Some are protected by water-resistant paints, preventative coatings or other chemical barriers, such as oil. It also is possible for one to reduce the chances of rust forming by using a dehumidifier or desiccant to help remove moisture from the air, but this usually is effective only in relatively small areas.

Steel is often galvanized to prevent iron oxide from forming; this process usually involves a very thin layer of zinc being applied to the surface. Another process, called plating, can be used to add a layer of zinc, tin or chrome to the metal. Cathodic protection involves using an electrical charge to suppress or prevent the chemical reaction that causes rust from occurring.

Quite interesting about oxygen and its interaction capabilities!


“Oxygen, although it is essential for aerobic organisms for respiration as well as energy production, has been therapeutically used for a long time. It also can be either toxic or lethal for humans if it is continuously inhaled pure for about 60 hours.”

U.S. National Library of Medicine/National Institute of Health http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231820/


Part I Raising awareness of both positives and negatives of oxygenation medically and in our environment!

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Now don’t get me wrong oxygen is an element that is a must for most creatures that live in the world both now and since it began but there is dangers to any element especially if mixed with some other element causing a negative result in the end. So you wonder how oxygenation can have pros and cons and why oxygen would ever have dangers to it, well let’s take a deeper look.

Oxygenation may refer to:

Oxygen saturation (medicine), the process by which concentrations of oxygen increase within a tissue

Oxygenation (environmental), a measurement of dissolved oxygen concentration in soil or water

Great Oxygenation Event, an ancient event that led to the rise of oxygen within our atmosphere

Water oxygenation, the process of increasing the oxygen saturation of the water

Dioxygen complex, the chemical details of how metals bind oxygen

Of course, oxygen has its good points. Besides being necessary for respiration and the reliable combustion engine, it can be liquefied and used as rocket fuel. Oxygen is also widely used in the world of medicine as a means to imbue the body with a greater amount of the needed gas. But recent studies indicate that administering oxygen might be doing less good than hoped—and in fact be causing harm. No one is immune to the dangers of oxygen, but the people who might most suffer the ill effects are infants newly introduced to breathing, and those who are clinically deceased.

Oxygen regarding the medical view:

There are a variety of injuries and ailments for which modern medicine dictates oxygen therapy. Look at the medical aspect, the common wisdom is that by filling the lungs with pure O2, one is pushing more of the vital gas into the blood, and thus to organs that are weakened and in need of support. It has also long been known that even at partial pressures, pure oxygen can be toxic—a fact with which scuba divers and astronauts are intimately familiar. Recent studies have indicated that the human body responds to pure oxygen, even at normal pressures, in a negative way.

When pure O2 is introduced to the lungs, autonomic reflex increases respiration. The increased rate of breathing means that a much larger load of carbon dioxide is released from the body, which causes the blood vessels to constrict. Despite the increased amount of available oxygen in the lungs, the circulatory system is hampered, and cannot deliver precious O2 as well as it could when breathing normal atmosphere.

Ronald Harper, a neurobiology professor at UCLA, conducted observations on a group of healthy teenagers breathing various gas mixes using functional magnetic resonance imaging (fMRI). His findings showed that in some subjects the pure O2 caused the brain to go clinically bonkers. Brain structures such as the hippocampus, the insula, and the cingulate cortex all displayed an adverse reaction; they in turn spurred the hypothalamus, the body’s main regulatory gland, into a fervor. The hypothalamus regulates a myriad of things, including heart rate, body temperature, and is the master of a variety of other glands. The introduction of pure oxygen prompts the hypothalamus to flood the body with a cocktail of hormones and neurotransmitters which serve to hamper heart rate, and further reduce the circulatory system’s effectiveness. But Harper also found that by adding a mere 5% CO2, all the detrimental effects found in pure oxygen are negated.

There are circumstances, however, where even the proper mix of gases would prove inadequate. Modern medicine has long taught that after respiration stops, the brain can only survive for six to seven minutes without oxygen before its cells begin to die in droves. In order to combat this, standard procedure has been to aggressively attempted to restore breathing and heartbeat immediately upon cessation, CPR. The base premise on which this protocol is designed may be in error but only if continuing longer than the AHA guides us to do CPR. For there is more than just to lack of oxygen in patients who die having CPR done to them for death (Ex Exacerbation of a disease, multi – organ failure, years of CHF, etc… Even thought lack of 02 is part of the reason for the death in the end. There was a cause for it happening and leading to lack of 02 is the prime entity to death of all diseases leading up to this in a human.).

Upon examining heart cells and neurons deprived of oxygen under a microscope, Dr Lance Becker of the University of Pennsylvania found there was no indication that the cells were dying after five or six minutes. In fact, they seemed to endure the state for up to an hour without adverse affect. Given this unexpected observation, the researchers were forced to investigate why human resuscitation becomes impossible after only a few minutes of clinical death. The answer they uncovered was that the body’s cells were not dying of oxygen starvation; they were expiring due to Reperfusion—the sudden reintroduction of oxygen to a dormant cell = Programmed cell death! The cells reintroducing oxygen back into the cell from outside the cell in the bloodstream caused the destruction of the red blood cells, the RBCs carry oxygen to all our tissues sites. You would think that would save the cells in sending more oxygen out to the tissues but like we’re told from childhood too much of almost anything can hurt or kill you (Ex. Food/work/stress…)

Take a patient with severe emphysema they do get oxygen in their body but the problem is that oxygen gets air spaced elsewhere rather than all the 02 breathed in going in the red blood cells at the lungs exchange for 02 at the bottom of the lungs with CO2 (carbon dioxide) sent from the cells to the lungs to leave the body. Than the cells go off throughout the bloodstream having our tissues utilize from the red blood cells the oxygen it needs (a transfer of 02 to our tissues).   Upon return of the red blood cells that took the CO2 from the tissues to keep the tissues more oxygenated, so they can do their function as an organ. Oxygen deprivation to a severe state is Oxygen Starvation to our bodies leading to death, if not reversed. Also with the severe COPD emphysema pt their body adjusts to having high C02 levels compared to a person without emphysema. A normal person’s brain functions to sending messages out to cause us to breath when our 02 level is low but to a severe emphysema pt the low C02 levels causes their brain to send out messages to breath, so if you give an emphysema pt over 2L of 02 for several hours if will turn the brain off and the pt deceases (except when a emphysema pt is in respiratory distress since it is needed and temporary support of higher oxygen levels than when stable and out of respiratory distress their at 2L of 02 again).

Inside the cells, the culprit seems to be in the mitochondria, which is the cell’s power plant where sugar and oxygen are converted to usable energy. Mitochondria are also responsible for apoptosis—the organized, controlled self-destruction of a cell. Normally apoptosis occurs in situations such as the cell being damaged beyond repair, infected by a virus, an attempt to prevent cancer, or aiding in initial tissue development. The process effectively kills and dismantles the cell allowing the body’s usual waste management functions to carry the cell’s remains away. For reasons not entirely clear, reperfusion triggers apoptosis—the oxygen intended to save the cell actually causes cellular suicide.

Armed with this new information about how cells react to oxygen, it is clear that current emergency care is not altogether ideal, and new protocols are under investigation. Dr Becker proposes that induced hypothermia may slow cell degradation, and if a means can be found to safely reintroduce oxygen to tissues, a clinically dead person—who still has trillions of living cells—could be resuscitated after being an hour dead.

This glorious future is still on the horizon, but to imagine the practical application leads one to ponder the multitude of accidents and injuries that are currently fatal, but will one day be treatable. Emergency Medical Personnel could arrive on the scene, and inject the patient with a slurry of ice and salt that lowers the body temperature to about 92° F. In a hypothermic state, the patient is hauled to the hospital, where instead of frantically trying to restart the heart, doctors patch up the problem, prevent apoptosis , and then restart the heart. Though it won’t save everyone, these findings may lead to a future where a person made up of perfectly good human cells is not written off as dead merely because their heart has stopped beating. The miracle of modern medicine, it seems, is on the cusp of determining the true distinction between dead and mostly dead.



Part III The Treatment of Parkinson’s Disease.

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Parkinson’s disease is the second most common progressive, neurodegenerative disease after Alzheimer disease. Parkinson’s disease is named after James Parkinson, a 19th century general practitioner in London. Parkinson’s disease is characterised by pathologic intra-neuronal α–synuclein-positive Lewy bodies and neuronal cell loss. Classically this process has been described as involving the dopaminergic cells of the substantia nigra pars compacta, later becoming more widespread in the CNS as the disease progresses. However, recently there has been a growing awareness that the disease process may involve more caudal portion of the CNS and the peripheral nervous system prior to the clinical onset of the disease.1 Parkinson’s disease affects movement, muscle control, balance, and numerous other functions.

MEDS: The combination of levodopa and carbidopa (Brand names Sinemet, Parcopa, Duopa® (as a combination product containing Carbidopa, Levodopa=Rytary® (as a combination product containing Carbidopa, Levodopa).

Levodopa and carbidopa are used to treat the symptoms of Parkinson’s disease and Parkinson’s-like symptoms that may develop after encephalitis (swelling of the brain) or injury to the nervous system caused by carbon monoxide poisoning or manganese poisoning. Parkinson’s symptoms, including tremors (shaking), stiffness, and slowness of movement, are caused by a lack of dopamine, a natural substance usually found in the brain. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. This allows for a lower dose of levodopa, which causes less nausea and vomiting.

Medications are commonly used to increase the levels of dopamine in the brain of patients with Parkinson’s disease in an attempt to slow down the progression of the disease. Dopaminergic agents remain the principal treatments for patient with Parkinson’s disease, such as Levodopa and Dopaminergic agonist. In many patients, however, a combination of relatively resistant motor symptoms, motor complications such as dyskinesias or non-motor symptoms such as dysautonomia may lead to substantial disability in spite of dopaminergic therapy. In recent days, there has been an increasing interest in agents targeting non-motor symptoms, such as dementia and sleepiness.

As patients with Parkinson’s disease live longer and acquire additional comorbidities, addressing these non-motor symptoms has become increasingly important. Among anti-depressants, Amitriptiline and SSRI are commonly used, while Rivastigmine became the first FDA approved medication for the treatment of dementia associated with PD.

SURGERY:   Surgery for Parkinson’s disease has come a long way since it was first developed more than 50 years ago. The newest version of this surgery, deep brain stimulation (DBS), was developed in the 1990s and is now a standard treatment. Worldwide, about 30,000 people have had deep brain stimulation.

Lifestyle modifications have been shown to be effective for controlling motor symptoms in the early stages of Parkinson’s disease. The surgical treatment options available for Parkinson’s patients with severe motor symptoms are pallidotomy, thalamotomy and Deep Brain Stimulation (DBS).

The novel approaches for treatment of Parkinson’s disease that are currently under investigation include neuroprotective therapy, foetal cell transplantation, and gene therapy.

What is DBS?

DBS was introduced two decades ago and has gained widespread popularity as a surgical treatment for medically refractory Parkinson’s disease. DBS is a reversible procedure that has advantage over surgical lesioning (pallidotomy) and unilateral brain stimulation. DBS is comparable in efficacy to unilateral surgical lesioning7 while bilateral subthalamic nucleus stimulation is superior to pallidotomy. DBS is FDA approved for the treatment of medically refractory Parkinson’s disease and ET. DBS has proven its efficacy in the treatment of cardinal motor features of Parkinson’s disease such as bradykinesia, tremor and rigidity and it is unresponsive for non-motor symptoms such as cognition, speech, gait disturbance, mood and behaviour. Long-term studies have demonstrated that many of these effects last for long as long as levodopa responsiveness in maintained

During deep brain stimulation surgery, electrodes are inserted into the targeted brain region using MRI and neurophysiological mapping to ensure that they are implanted in the right place. A device called an impulse generator or IPG (similar to a pacemaker) is implanted under the collarbone to provide an electrical impulse to a part of the brain involved in motor function. Those who undergo the surgery are given a controller, which allows them to check the battery and to turn the device on or off. An IPG battery lasts for about three to five years and is relatively easy to replace under local anesthesia.

Is DBS Right for Me?

Although DBS is certainly the most important therapeutic advancement since the development of levodopa, it is not for every person with Parkinson’s. It is most effective – sometimes, dramatically so – for individuals who experience disabling tremors, wearing-off spells and medication-induced dyskinesias.

Deep brain stimulation is not a cure for Parkinson’s, and it does not slow disease progression. Like all brain surgery, deep brain stimulation surgery carries a small risk of infection, stroke, or bleeding. A small number of people with Parkinson’s have experienced cognitive decline after this surgery. That said, for many people, it can dramatically relieve some symptoms and improve quality of life. Studies show benefits lasting at least five years.

Gamma Knife radiosurgery

 Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target deep brain regions to create precise functional lesions within the brain, with no surgical incision. Gamma Knife may be a treatment option for patients with Parkinson’s tremor who are high risk for surgery due to medical conditions or advanced age.

As the nation’s leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

It is very important that a person with Parkinson’s who is thinking of treatment from meds to surgery to possiby Gamma Knife radiosurgery be well informed about the procedures and realistic in his or her expectations. This means there’s no standard treatment for the disease – the treatment for each person with Parkinson’s is based on his or her symptoms.








By definition, Parkinson’s is a progressive disease. Although some people with Parkinson’s only have symptoms on one side of the body for many years, eventually the symptoms begin on the other side.

Parkinson’s Disease Foundation

Part II Signs and Symptoms with Diagnosis of Parkinson’s Disease

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What are the signs and symptoms (s/s) of this disease?

The early signs and symptoms of Parkinson’s disease that are often overlooked by both patients and doctors because the symptoms are subtle and the progression of the disease is typically slow. S/S of parkinson’s disease are:

Parkinson’s disease does not affect everyone the same way. In some people the disease progresses quickly, in others it does not. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and different symptoms are more troublesome.

  • The tremors associated with Parkinson’s disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. This is sometimes called “pill rolling.” Tremor usually begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. In three out of four patients, the tremor may affect only one part or side of the body, especially during the early stages of the disease. Later it may become more general. Tremor is rarely disabling and it usually disappears during sleep or improves with intentional movement.
  • Rigidity, or a resistance to movement, affects most parkinsonian patients. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In Parkinson’s disease, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient’s arm, which will move only in ratchet-like or short, jerky movements known as “cogwheel” rigidity.
  • Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it is unpredictable. One moment the patient can move easily. The next moment he or she may need help. This may well be the most disabling and distressing symptom of the disease because the patient cannot rapidly perform routine movements. Activities once performed quickly and easily — such as washing or dressing — may take several hours.
  • Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily. When bumped from the front or when starting to walk, patients with a backward lean have a tendency to step backwards, which is known as retropulsion. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped.

As the disease progresses, walking may be affected. Patients may halt in mid-stride and “freeze” in place, possibly even toppling over. Or patients may walk with a series of quick, small steps as if hurrying forward to keep balance. This is known as festination.

A detailed overview of the Unified Parkinson’s Disease Rating Scale that is used by doctors to follow the course of disease progression and evaluate the extent of impairment and disability.


The Movement Disorder Society Task Force for Rating Scales for Parkinson’s Disease prepared a critique of the Unified Parkinson’s Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, “minimal,” “mild,” “moderate,” and “severe” PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments.

How Parkinson’s disease is diagnosed based on factors such as signs/symptoms, patient history, physical examination, and a thorough neurological evaluation.

Furthermore, making the diagnosis is even more difficult since there are currently no blood or lab tests available to diagnose the disease. Some tests, such as a CT Scan (computed tomography) or MRI (magnetic resonance imaging), may be used to rule out other disorders that cause similar symptoms. Given these circumstances, a doctor may need to observe the patient over time to recognize signs of tremor and rigidity, and pair them with other characteristic symptoms.

The doctor will also compile a comprehensive history of the patient’s symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will likely be followed up with a rigorous physical exam with concentration on the functions of the brain and nervous system. Tests are conducted on the patient’s reflexes, coordination, muscle strength, and mental function. Making a precise diagnosis is essential for prescribing the correct treatment regimen. The treatment decisions made early in the illness can have profound implications on the long-term success of treatment.

Recommended Related to Parkinson’s

10 Questions to Ask Your Doctor About Parkinson’s Disease

Since you’ve recently been diagnosed with Parkinson’s disease, ask your doctor these questions at your next visit. 1. What stage is my illness in now? 2. How quickly do you think my disease will progress? 3. How will Parkinson’s disease affect my work? 4. What physical changes can I expect? Will I be able to keep up the activities, hobbies, and sports I do now? 5. What treatments do you suggest now? Will that change as the disease progresses? 6. What are the side effects of medication?…

Read the 10 Questions to Ask Your Doctor About Parkinson’s Disease article > >

Because the diagnosis is based on the doctor’s exam of the patient, it is very important that the doctor be experienced in evaluating and diagnosing patients with Parkinson’s disease. If Parkinson’s disease is suspected, you should see a specialist, preferably a movement disorders trained neurologist.

A comprehensive overview of the major non-motor complications that are often associated with Parkinson’s disease, including:

-Cognitive impairment –Dementia –Psychosis –Depression –Fatigue -Sleep disturbances -Constipation -Sexual dysfunction -Vision disturbances.


“Parkinson’s disease is a progressive disorder of the nervous system that affects movement. While a tremor may be the most well-known sign of Parkinson’s disease, the disorder also commonly causes stiffness or slowing of movement.”