Understanding Parkinson's

Symptoms

A Picture of Parkinsons

Historically,  most clinicians thought about and addressed Parkinson’s symptoms from the motor complications aspect of the disease. Indeed, the hallmark symptoms used to identify PD are all observable – balance, tremor, slowness of movement and rigidity. However, ask any one living with Parkinson’s and you will learn there is so much more.

Early signs of Parkinson’s might include:

  • Tremor, one of the most visible signs. However, up to one third of those diagnosed never experience tremor.
  • Changes in gait or difficulty with walking.
  • Changes in speech and communication, such as lowered vocal tone.
  • Smaller or cramped handwriting
  • Loss of smell.
  • Constipation.
  • Sleep issues.
  • Dizziness or fainting.

Motor Complications

Motor or movement symptoms of Parkinson’s disease are more widely associated with PD and are how many physicians diagnose Parkinson’s in patients.

  • Resting tremor: considered a classic sign of Parkinson’s, this is a rhythmic, involuntary shaking that can be experienced in a hand, finger or limb when it is relaxed and disappears during voluntary movement. However, about 30% of people living with Parkinson’s do not experience tremor.
  • Bradykinesia (slowness of movement): everything slows down with Parkinson’s because there is a decrease in voluntary and spontaneous movement. This could look like decreased arm swing when walking, slower walking, decreased blinking or facial movements.
  • Rigidity (stiffness): muscle stiffness can occur, effecting movements and can be detected by a physician during an examination.
  • Postural instability (balance issue): difficulty staying upright and maintaining balance and coordination increases risk of falls. This symptom can present with gradual changes at first and lead to more significant changes as the disease progresses.

 Other motor symptoms may include dystonia (cramping), freezing (stuck in place), festination (quick, short steps), micrograhpia (small handwriting), hypophonia (soft speech), or hypomimia (masked face).

Non-Motor Symptoms

As Parkinson’s is unique to each individual living with the diagnosis, the list of non-motor symptoms may vary from person to person. As these symptoms come up it is important to discuss them with your doctor and learn how to best manage them with medication, exercise or other therapeutic interventions. It is also important to share these symptoms with your care partner or loved ones, as many of these are considered the “invisible” symptoms of Parkinson’s, but deeply impact your quality of life.

Some non-motor symptoms could include orthostatic hypotension (blood pressure regulation issue), sleep disorders, fatigue, constipation, depression, anxiety, sexual problems, pain, or early satiety (feeling full after eating small amounts).

Mood and Cognition

The same changes in the brain that may lead to motor symptoms can also create a slowness in thinking and memory. Some changes could include difficulty with focusing, feeling overwhelmed, trouble finding the right words, challenges with problem-solving/executive function and visuospatial impairment.

As Parkinson’s progresses there is a risk for some (not all) people to develop Parkinson’s related dementia. If dementia symptoms present before or at the same time as other symptoms of PD, it is likely Lewy body dementia (LBD). It is important to communicate with healthcare providers about changes you may notice to ensure adequate care and support.

Due to the nature of Parkinson’s targeting dopamine in the brain, this can affect the person with PD’s mood and lead to depression or apathy. Side-effects of Parkinson’s medications can also contribute to a change in behavior, such as impulse control and personality changes.

If you suspect Parkinson's

Get expert advice

If you suspect Parkinson’s disease, start with a conversation with your primary care physician. Discuss your concerns and any symptoms you’ve noted. If your provider shares your concerns, you may be referred to a neurologist or movement disorder specialist for further evaluation. Contact PRO if you need help finding a specialist or getting the conversation started.

If you suspect Parkinson's

Get expert advice

If you suspect Parkinson’s disease, start with a conversation with your primary care physician. Discuss your concerns and any symptoms you’ve noted. If your provider shares your concerns, you may be referred to a neurologist or movement disorder specialist for further evaluation. Contact PRO if you need help finding a specialist or getting the conversation started.