Early symptoms of Parkinson’s disease are usually mild and generally occur gradually. Patients may have fatigue or a general sense of uneasiness. They may feel a slight tremor or have difficulty standing, some may notice that their speech has become softer or that their handwriting has changed. Patients may forget a word or thought and have feelings of depression or anxiety. Generally, friends and family may begin to notice the changes before the patient does. They often notice the stiffening or lack of movement, or the absence of facial expression ("masked face").
As the disease progresses, it begins to interrupt daily activities, when this occurs it is considered late-stage Parkinson’s disease. It is important to note that not all patients experience the full range of symptoms, in fact most Parkinson’s patients have mild, non-intrusive symptoms.
Major symptoms of Parkinson’s disease
Muscle rigidity.
Rigidity is the inability for the muscles to relax normally. Rigidity is seen in Parkinson’s patients when the physician moves the arm or leg. Rarely, patients may feel stiff. Most patients with Parkinson's disease develop some degree of rigidity, or stiffness of limbs. This rigidity is caused by uncontrolled tensing of muscles and results in the patient being unable to move about freely. Also, patients may experience aches or pains from affected muscles.
Tremors.
In general tremor (shaking) begins in the hands and arms, although it can also occur in the jaw or foot. Tremor typically involves the rubbing of the thumb against the forefinger and is more apparent when the hand is at rest or the patient is under stress. In the early stages of the disease, it usually only affects one side of the body or one limb. As Parkinson’s progresses, tremor may become more generalized. Tremor usually worsens with stress. Tremor rarely disables a patient and often disappears during sleep and when the arm or leg is being moved. Not every patient with Parkinson’s disease has tremor.
Bradykinesia:
Bradykinesia is the slowing down of movement and the gradual loss of spontaneous activity. It is caused by the brain’s slowness in transmitting the necessary instructions to the appropriate parts of the body. This symptom is especially stressful for Parkinson’s patients, given that it is unpredictable and can be quickly disabling. One moment a patient is moving easily, the next moment they need help to move at all. This makes accomplishing simple tasks and participating in daily routines extremely difficult. Bradykinesia affecting the facial muscles may cause a mask-like appearance.
Changes in walking pattern (gait).
This commonly includes the inability of a patient to swing their arms naturally while walking, taking short shuffling steps, "freezing spells" (difficulty starting to walk and difficulty stopping) and difficulty in maneuvering turns and corners.
Other symptoms
- Loss of balance, falls
- Forward or backward lean that makes them more likely to fall
- Stooped posture (when the head is bowed and the shoulders are slumped)
- Shaking of the head
- Voice and speech changes; voice will become softer, with poor annunciation
- Loss of motor skills
- Memory problems
- Changes in handwriting; smaller writing
- Constipation
- Depression
- Feelings of fear and anxiety
- Confusion
- Dementia
- Seborrhea (oily skin)
- Muscle atrophy (weakness)
- Fatigue
- Drooling
- Skin problems, such as dandruff
- Difficulty swallowing and chewing
- Anxiety, stress and tension
- Sleep disturbance
- Urinary problems
- Sexual dysfunction
It is important for you to visit your doctor if you are experiencing any of these symptoms so you can receive the proper evaluation and diagnosis. There are other conditions that appear similar to Parkinson’s disease, including:
- Depression
- Aging
- Effects of anti-psychotic drugs
- Other degenerative disorders of the brain
If there is any question about the possibility of Parkinson’s disease, consider consultation with an expert, such as a Movement Disorders Specialist.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
Ask a Health Educator, Live!
Know someone who could use this information?...send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/23/2001
