What are the symptoms of Parkinson's disease?
Four Main Motor Symptoms of PD:
- Shaking or tremor at rest.
- Slowness of movement, called bradykinesia.
- Stiffness or rigidity of the arms, legs or trunk.
- Trouble with balance and falls, also called postural instability. Postural instability usually appears later with disease progression and may not be present with initial diagnosis.
Secondary Symptoms of PD May Include:
- Small, cramped handwriting, called micrographia.
- Reduced arm swing on the affected side.
- Slight foot drag on affected side creating a shuffled walk.
- “Freezing”—a term used to describe the phenomenon of being “stuck in place” when attempting to walk.
- Loss of facial expression due to rigidity of facial muscles, called hypomimia.
- Low voice volume or muffled speech, called hypophonia.
- Tendency to fall backwards, called retropulsion.
- Decrease ability in automatic reflexes such as blinking and swallowing.
Other Symptoms of PD
- Depression
- Anxiety- beyond the normal response to stress
- Hallucinations, psychosis
- Sleep disturbances (vivid dreams, talking and moving during night sleep)
- Constipation
- Pain
- Increase in dandruff (seaborrhea dermatitis) or oily skin
Table 1. Symptoms in Parkinson’s disease
| MOTOR SYMPTOMS |
| Bradykinesia (slowness of movement) |
| Rigidity (stiffness of movement) |
| Tremor (involuntary shaking of the hands, feet, arms, legs, jaw, or tongue, usually more prominent at rest) |
| Postural Instability (tendency to fall without explanation, usually when pivoting) |
| NON-MOTOR SYMPTOMS |
| Mood (depression, anxiety, irritability) |
| Cognitive changes (attention, visuo-spatial problems, memory problems, personality changes, psychosis/hallucinations) |
| Orthostatic hypotension (lightheaded and low blood pressure upon standing) |
| Constipation and early satiety (a feeling of fullness after eating small amounts) |
| Hyperhidrosis (excessive sweating), especially of hands and feet |
| Seborrhea dermatitis (dry skin) dandruff |
| Urinary urgency, frequency and incontinence |
| Loss of sense of smell (Anosmia) |
| Sleep disorders |
| Insomnia, Excessive Daytime Sleepiness (EDS), Rapid Eye Movement Behavioral Disorder (RBD) or active dreaming, dream enactment, involuntary movements and vocalizations during sleep, Restless Legs Syndrome (RLS)/Periodic Leg Movements Disorder (PLMD) |
| Sensory (pain, tightness, tingling, burning) |
| MIXED MOTOR AND NON-MOTOR SYMPTOMS |
| Drooling due to slowed swallowing (Sialorrhea) |
| Speech and swallowing problem |
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Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.
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