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Symptoms of Parkinson’s Disease

Symptoms often start on one side of the body and usually remain worse on that side, even after symptoms begin to affect both sides. PD symptoms are classified
as motor symptoms and non-motor symptoms.

 

Parkinsons Disease Diagram

Motor (Movement) Symptoms

Motor (movement) symptoms are the most common visible symptoms of PD that could be noticeable by others. These include tremor, stiffness, slowness, and more.

Tremor

Tremor in PD is a rhythmic involuntary shaking that occurs in a finger, hand, or leg while at rest or the body is relaxed sitting or standing. Early in the disease, when the limb that is shaking makes voluntary movement, the shaking stops. However, the tremor recurs when the body or the affected limb rests. As the disease progresses, the tremor extends to unaffected limbs, chin, or lips.

Tremors can worsen when there are intense emotions (excitement or anxiety) and physical stress, like being sick. Although tremor is one of the common symptoms of PD, not everyone with PD has tremors. Also, not everyone with tremors has PD, as other conditions can cause tremors. It is essential to see a neurologist to get an accurate diagnosis.

Stiffness

Stiffness (rigidity) is an increased resistance when a limb is moved passively. Like tremor, stiffness usually begins on one side and extends to other limbs and torso as the disease progresses. Rigidity can affect any part of the body, like the legs, face, neck, and more, and may be associated with tightness, aches, or pain in the affected area. Stiffness can affect joints
and cause reduced arm swing.

Slow Movements

Slow movements are noticeable, with general movements such as walking, standing up, getting in and out of bed, turning in bed, and more. Generally, these movements take longer than usual. Other symptoms affected by slow movements are reduced facial expression (masked-face), decreased blinking, difficulty with fine movement coordination like writing and buttoning a shirt. Speech can be soft, slow when talking with others, and hard to understand. As the disease progresses, slow movements can affect swallowing, leading to excessive saliva and drooling.

Balance Problems

Balance problems (postural instability) is a symptom that can occur anytime during the course of the disease; however, it is more pronounced as the disease advances. When balance is affected, a sense of unsteadiness, maintaining an upright posture, a tendency to fall, and frequent falls can occur.

Walking (Gait) Difficulty

Walking is affected by slow movements and balance problems. Walking steps may be slow and small, and a shuffling gait may occur. Walking problems can also include the tendency to lean forward and charge with small and rapid steps. Freezing of gait can occur later in the disease, causing feet to feel stuck to the floor and inability to take a step forward when walking.

Other Motor Symptoms

Other motor symptons Include small handwriting, dystonia (abnormal muscle tone), curling of toes, neck pulling, muscle spasms, and cramping.

 

 

Non-Motor (Movement) Symptoms

PD is a complex disease that also involves non-motor symptoms like mental health disorders, memory, and more.

Constipation

Constipation may occur several years before motor symptoms. Symptoms include having fewer than three bowel movements pre-week and difficulty and straining to pass bowel movements.

Low Blood Pressure (Orthostatic Hypotension)

Low blood pressure is a common symptom caused by a drop of blood pressure when changing a position from lying to sitting or from sitting to standing. The quick drop in blood pressure can lead to dizziness, lightheadedness, or fainting.

Urinary Problems

People with PD may experience bladder problems, including urinary frequency, urgency, incontinency, and frequent nighttime urination. When there is a sensation to urinate, patients may have difficulty holding urine until reaching the bathroom and may experience accidents.

Anxiety

Anxiety is one of the common non-motor PD symptoms. Patients feel apprehensive and restless about what is to come. Patients may experience increased anxiety when going to unfamiliar places, moving, going to social functions, and may be afraid to leave the house.

Depression

Due to the lack of dopamine in the brain, people with PD may experience sadness, loss of energy, reduce desire to engage in activities, feelings of worthlessness or guilt, and more. Because of depression, patients might withdraw from socializing and being involved in activities they used to enjoy.

Apathy

Apathy is the lack of motivation to do anything, including think, speak, and act. People who experience apathy might lack the impulse or motivation to engage in activities. Apathy is different from depression. Depression has feelings of sadness, worthlessness; however, apathy
feels no emotions or shows falt emotions.

Sleep Problems

People with PD may experience various sleep problems, including difficulty falling asleep and staying asleep, excessive daytime sleepiness, restless leg syndrome, and more. Some people might have vivid dreams and may act out their dreams by yelling, talking, punching, and moring
their hands and legs, causing injury to themselves and the person sleeping with them.

Memory or Thinking (Cognitive) Problems

People with PD might experience difficulty with concentration, easily be distracted from performing tasks, and disorganize thought processes, making planning difficult. Patients might experience mild thinking changes early in the disease, and it might continue to progress slowly. People might find it challenging to continue working as it might require them more time and effort to accomplish tasks. Later in the disease, people may develop dementia, a gradual memory loss. In addition to the
thinking problems, patients might have difficulty with short-term memory, forgetting things that happened recently. They might also have difficulty with word-finding and getting confused in an
unfamiliar environment.

Psychosis (Hallucinations and Delusions)

People with PD might develop psychosis, see things that are not there (visual hallucinations), and having false beliefs (delusions). Patients might see small animals like dogs, cats, or mice, or
figures of people, which can be frightening. Patients who experience delusions might think that someone is stealing from them or their spouse is cheating on them.

Smell loss

A reduced sense of smell is one of the early signs that can occur years before the diagnosis of PD. Not everyone with a loss of smell will develop PD. People with loss of smell may not notice the symptom.

Speech problems

People with PD may develop soft and monotone voice. Sometimes words are difficult to understand as words might be slurred or mumbled.

Other non-Motor Symptoms:

Include skin changes, swallowing problems, drooling, vision changes (blurred or double vision), and weight changes.