Secrets of the shaking palsy.


slight twitching in your finger. You imagine that it will go away, but it worsens, turning into a tremor of your hand and eventually your entire arm. Your ever-clenching muscles begin to feel stiff, sore and weak. You find it harder to lift things. In time, you become reluctant even to get up from a chair and walk. Your posture begins to slump forward. Your gait shortens. Your speech slows. Your face, once expressive, becomes an immobile mask. Over the years, in the absence of medication, these symptoms will inexorably spread and worsen. Eventually, as the British physician James Parkinson wrote in An Essay on the Shaking Palsy in 1817, “The submission of the limbs to the direction of the will can hardly ever be obtained in the most ordinary offices of life”— such as feeding oneself, or grasping and lifting a glass of water. Even muscles that normally work automatically are affected: swallowing becomes difficult, drooling becomes common and, at the other end of the line, moving the bowels requires, as Parkinson put it, “stimulating medicines of very considerable power.” To this list of common symptoms noted by Parkinson, modern neurologists have added a diminished sense of smell, sleep disorders, restless-leg syndrome, depression, anxiety, hallucinations, fatigue, impotence, visual problems and, in late stages, a form of dementia. The actor Michael J. Fox, now a 20-year veteran of Parkinson’s disease, has called it “the gift that keeps on taking.”

DOI: 10.1038/466S2b

Cite this paper

@article{Schnabel2010SecretsOT, title={Secrets of the shaking palsy.}, author={Jim Schnabel}, journal={Nature}, year={2010}, volume={466 7310}, pages={S2-5} }