Self perceived weakness in Parkinson's disease

Background: Parkinson's disease (PD) has been known as "The Shaking Palsy" as well as "Paralysis Agitans", yet clinically apparent weakness is not a feature of the disorder. Relative weakness, and early muscle fatigue may be demonstrated on testing but frank weakness should not be apparent on routine clinical examination. Aim: To determine the prevalence of self perceived weakness (SPW) and whether this feeling was associated with the sense of fatigue. Methods: We asked 113 consecutive PD patients, who had no demonstrable weakness on routine neurological exam and were able to provide reliable answers, whether they perceived themselves to be weak, and whether they felt fatigued. We did not use a fatigue questionnaire or measure strength. The motor scale of the Unified Parkinson's Disease Rating Scale was also used to evaluate every subject. Results: Self perceived weakness was reported by 43.8%. Self perceived weakness was associated with fatigue but not with bradykinesia, tremor or total motor score (motor severity). SPW is common in PD but affects less than half the studied population. SPW appears to be related to fatigue, a major determinant of quality of life in PD, and therefore is an important symptom to understand. (C) 2012 Elsevier Ltd. All rights reserved.