Parkinson's disease symptoms are different for different people. Some are hard for even doctors to detect. Others are obvious even to an untrained eye. Visit a movement disorder specialist if you think you're experiencing Parkinson's symptoms.
People are usually more familiar with the motor (movement) symptoms of Parkinson's disease (PD). These signs are noticeable from the outside and are used by doctors to make a diagnosis. The three "cardinal" motor symptoms of PD are:
- Stiffness (rigidity): muscle stiffness detected by a doctor on examination
- Slowness (bradykinesia): decrease in spontaneous and voluntary movement; may include slower walking, less arm swinging while walking, or decreased blinking or facial expression
- Resting tremor: a rhythmic, involuntary shaking that occurs in a finger, hand or limb when it's relaxed and disappears during voluntary movement
Not everyone with Parkinson's experiences all three motor symptoms, but slowness always is present. And although tremor is the most common symptom at diagnosis, not everyone with Parkinson's has tremor.
Other motor symptoms — walking problems or difficulty with balance and coordination (postural instability) — also may occur. These can happen any time in the course of Parkinson's, but are more likely as the disease advances.
Non-motor (non-movement) symptoms sometimes are called the "invisible" symptoms of Parkinson's because you can't see them from the outside. These common symptoms can affect almost every body system, occur any time in the course of disease (even before motor symptoms or diagnosis) and differ in severity from person to person. Non-motor symptoms can significantly impact quality of life for people with Parkinson's and their families. They may include:
Parkinson's can affect the automatic/involuntary functions that our bodies perform to keep us alive.
- Constipation: decreased or difficult-to-pass bowel movements
- Low blood pressure (orthostatic hypotension): decrease in blood pressure when changing positions, such as standing from sitting, which can cause lightheadedness, dizziness or fainting
- Sexual problems: erectile dysfunction in men; decreased libido or pain in women
- Urine problems: frequent urination, involuntary loss of urine (incontinence) or difficulty emptying the bladder (weak stream)
- Sweating problems: excessive perspiration, even when not hot or anxious
Mood and Thinking Changes
Parkinson's disease can impact how you feel and think.
- Apathy: lack of motivation and interest in activities
- Memory or thinking (cognitive) problems: vary widely; range from multitasking and concentration difficulties that don’t interfere with daily activities (mild cognitive impairment) to significant problems that impact a job and daily and social activities (dementia)
- Mood disturbances: depression (sadness, loss of energy, decreased interest in activities) and anxiety (uncontrollable worry)
- Psychosis: seeing things that aren't there (visual hallucinations) and having false, often paranoid, beliefs (delusions), such as that a spouse is being unfaithful or money is being stolen
Other Physical Changes
Parkinson's can cause other difficulties, as well.
- Drooling: build up of saliva because of decreased swallowing
- Excessive daytime sleepiness or fatigue: feeling drowsy, sluggish or exhausted; may be symptoms on their own or result from Parkinson's medications
- Pain: discomfort in one body part or the entire body
- Skin changes: oily or dry skin; increased risk of melanoma
- Sleep problems: insomnia (difficulty falling or staying asleep), restless legs syndrome (an uncomfortable sensation in the legs that goes away with moving them) or REM sleep behavior disorder (acting out dreams)
- Smell loss: decreased ability to detect odors
- Speech problems: speaking in a soft and monotone voice and sometimes slurring words or mumbling
- Swallowing problems: choking, coughing and clearing the throat when eating and drinking
- Vision changes: dry eyes, double vision and trouble reading
- Weight changes: mild to moderate weight loss
Talk to your doctor if you're experiencing these symptoms, especially if they are interfering with activities you want or need to do. For example, slowness of movement might make exercise more challenging or fatigue might make your workday less productive. Keep in mind that even if you have symptoms common among people with Parkinson's, they may be brought on by a completely different condition altogether.