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Keywords:

  • Premorbid personality;
  • Early diagnosis

Abstract

Ray Kennedy's Parkinson's disease probably began during his distinguished career as a professional soccer player at least 10 years before the first unequivocal physical signs and 14 years before the diagnosis was finally made, when he was 35-years old. Early prodromal symptoms included intermittent subtle disturbances of movement and posture affecting the right arm and leg, mild facial immobility, episodes of profound malaise and lack of energy, inner feelings of tremulousness, excessive unprovoked bouts of perspiration, and accompanying feelings of heat. Abnormalities of movement in the right arm can be seen in video footage of soccer games up to 8 years before his disability came to medical attention. Many of his premorbid personality traits are characteristic of those believed to be associated with the subsequent development of the malady. At least in some patients with Parkinson's disease, the search for instigating aetiological factors should focus 10–20 years before the cardinal signs can be recognised with certainty.