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Non-Motor Symptoms

Parkinson’s disease is generally thought of as a disease that only involves movement. But in addition to so-called motor symptoms such as slowness of movement, tremor Involuntary shaking of the hands, arms, legs, jaw or tongue. The typical Parkinson’s tremor is “pill-rolling” – it looks like holding a pill between thumb and forefinger and continuously rolling it around. Some people report an internal tremor, a shaking sensation inside the chest, abdomen or limbs that cannot be seen. Most Parkinson’s tremor is “resting tremor,” which lessens during sleep and when the body part is actively in use.​ and stiffness, most people develop other health problems related to Parkinson's. These symptoms are diverse but are collectively known as non-motor symptoms.

It’s important to realize that non-motor symptoms are common and can be more troublesome and disabling than motor symptoms. That’s why you should watch for these symptoms and discuss early changes with your doctor. Research shows that people develop some non-motor symptoms, like depression A mood disorder whose symptoms can include a persistent sad or empty mood, feelings of hopelessness or pessimism, irritability and loss of interest or pleasure in previously enjoyable activities., sleep problems and loss of smell, years before they get a Parkinson’s diagnosis.

Non-motor symptoms can include:

  • Mood disorders such as depression, anxiety A feeling of nervousness, worried thoughts and physical distress. and irritability
  • Cognitive changes such as problems with focused attention and planning, slowing of thought, language and memory difficulties, personality changes, dementiaA term used to describe a group of brain disorders that cause a broad complex of symptoms such as disorientation, confusion, memory loss, impaired judgment and alterations in mood and personality.
  • Hallucinations and delusions
  • Orthostatic hypotension A drop in blood pressure upon changing position from lying down or sitting to standing; can cause fainting. Also called postural hypotension. (a drop in blood pressure when standing, light-headedness)
  • Sleep disorders such as insomnia, excessive daytime sleepiness A chronic condition characterized by difficulty staying awake or paying attention; may be due to underlying sleep disorders, depression or some medications. (EDS), rapid eye movement behavior disorder (RBD), vivid dreams, talking and moving during sleep, restless legs syndrome (RLS)/periodic leg movements disorder (PLMD)
  • Constipation and early satiety (a feeling of fullness after eating small amounts)
  • Pain
  • Fatigue
  • Vision problems
  • Excessive sweating, especially of hands and feet, with no or little exercise
  • Increase in dandruff (seborrhea Oily skin. dermatitis) or oily skin
  • Urinary urgency, frequency and incontinenceInvoluntary urination or defecation.
  • Loss of sense of smell
  • Sexual problems
  • Weight loss or weight gain
  • Impulsive control disorders such as binge eating, excessive shopping or gambling, usually a side effect of medications

Mixed motor and non-motor symptoms

The same PD symptoms that occur in muscles of the body – tremor, stiffness and slow movement – can occur in the muscles used in speaking and swallowing, resulting in the following changes:

  • Soft voice
  • Drooling or excessive saliva due to slow swallowing
  • Speech and swallowing problems

Page reviewed by Dr. Joash Lazarus, NPF Movement Disorders Fellow, Department of Neurology at Emory University School of Medicine.

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