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A Study on the Non-Motor Symptoms of Idiopathic Parkinson’s Disease in Correlation with the Severity and Duration of Disease in a Tertiary Referral Hospital

Kalpana R., Assistant Professor of Neurology, SRM Medical College Hospital and Research Centre, SRM Nagar, Kattankulathur, Kancheepuram District, Tamil Nadu 603203, India. , Karnakaran K.1 , Kalpana R.2

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International Journal of Neurology and Neurosurgery 10(1):p 21-28, January - March 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10118.3

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Abstract

Aim: To determine the non-motor symptoms and to assess the stage and duration of the disease in patients above 50 years, with idiopathic Parkinson’s disease. To analyse the correlation of non-motor symptoms of Parkinson’s disease with the severity and duration of disease. Materials and Methods: Following the institutional ethical committee approval 105 patients who attended the Neurology department between July 2013 and July 2014 with Idiopathic Parkinson’s Disease as outpatient and inpatient were studied in a tertiary care referral medical college hospital in Chennai. Motor symptoms were assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) and stage of the disease with the Hoehn and Yahr staging. Non-motor Symptoms Questionnaire (NMS QUEST) which contains 30 items was used to determine the non-motor features and to correlate with the severity and duration of the illness was studied. Observation and Results: Among 105 patients studied, sixty seven belonged to the age group between 50 – 60 years, thirty patients belonged to age group between 61-70 years and eight patients were aged more than 70 years. Seventy five patients had the disease duration between 0 – 5 years, eighteen had duration of 5 – 10 yrs and twelve had the disease for more than 10 years. Upon observation 22.9% of the study population belonged to Hoehn and Yahr stage 1 and 1.5, 37.1% of the patients belonged to stage 2 and 2.5. Amid the rest, 32.2% had Stage 3 and stage 4 consisted of 7.6% of the study group respectively. The number of Non-motor Symptoms in Stages 1 and 1.5 were in the range of 2 to 5, Stages 2 and 2.5 were in the range of 3 to 9, Stages 3 were 6 to 11 and in stage 4 between 11 and 12. This study also revealed a higher occurrence of NMS like Nocturia (60%), urgency (44.8%) and constipation (52.4%), dizziness (43.8%), anxiety (34.3%), depression (34%), memory (37.1%), dreams (24.8%), sleepiness (22.9%) and hallucinations (24.8%). Conclusion: The most prevalent Non-motor symptoms are Autonomic dysfunction like Constipation, Nocturia, urgency and sweating, followed by insomnia, depression and memory disturbances followed by dizziness, drooling, falls and unexplained pains. NMS also shows an increase during the progression of the disease as the highest incidence was in the stages 3 and stage 4 (Hoehn and Yahr).

Keywords: Parkinson‘s Disease; Non-Motor Symptoms; Hoehn and Yahr Staging; Unified Parkinson’s Disease Rating Scale (UPDRS); Autonomic Symptoms; Cognitive Symptoms and Behavioural Symptoms. 

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10118.3

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