Symptoms

Parkinson’s disease is a condition which is both progressive, and chronic. There is no particular order of symptom onset and as with most disorders the disease effects individuals in different ways and each individual may be seen to exhibit a different collection of symptoms and respond to different treatments in different ways. Finally, the severity of the symptoms can also differ between individuals with some patients experiencing only minor motor disruptions where others may become severely disabled. The primary symptoms being:

  • Tremor (shaking):
  1. Tremor at rest, usually starting in the hands with circular movements in the thumb and forefinger, otherwise known as the ‘pill rolling’ tremor.
  2. Tendency to diminish upon voluntary actions and is only usually seen initially in one of the individuals’ arms.
  3. The tremor may become worse when excited, tired or stressed.
  4. First symptom seen in three quarters of parkinson’s disease sufferers and can further be seen in the tongue, lips and chin.
  5. The presence of a tremor however does not necessarily mean an individual is suffering from parkinson’s disease as many other conditions such as hyperthyroidism and encephalitis exhibit this symptom and although the disease is associated with a tremor, 30% of sufferers do not experience tremors.
  • Stiffness or rigidity of muscles:
  1. Trouble performing simple activities due to muscles feeling tense and stiff. Other difficulties may be seen in performing facial expressions, and finer motor movements such as finger control and body language.
  2. Other secondary effects of such a symptom may be experienced for example in problems associated with constipation, bladder weakness, depression, handwriting, speech and balance and also in swallowing. 
  3. This symptom may be detected in an individual as an increased resistance to passive limb motion.
  • Parkinsonian Gait:
  1. The distinctive unsteady walk that is associated with parkinson’s disease, akinesia and small shuffling steps (festination) followed by the need to run in order to maintain balance.
  2. Tendency to lean unnaturally forwards or backwards developing the Parkinsonian stance. Furthermore, an unstable, stooped, or slumped posture may be observed.
  3. May also result in myalgia and freezing when a movement may be stopped and inability to resume movement. Arm swing is diminished in Parkinsonian patients upon movement.
  • Poor balance may be observed due to the lack of reflexes which are required in the adjustment of posture to maintain balance on movement.
  • Bradykinesia (slowness of movement):
  1. Difficulty in initiating and completion of voluntary movements.
  2. Lack of Dopamine resulting in delayed transmission of signals from the brain to the skeletal muscles which leads to this symptom.
  3. A ‘mask-like' appearance may be seen due to bradykinesia and rigidity combined in the facial muscles.
  4. Bradykinsesia also is said to decrease size of movement upon initiation and also a lessening of unplanned movements.
  5. The symptom can also be seen as micrographia, hypophonia and hypomimia together with a decreased blink rate.

With these classical primary symtoms comes a vast array of secondary consequences also seen to be symptomatic in the diagnosis of Parkinson’s disease. Among these are:

  • Hypersalivation or excessive saliver production.
  • Excessive sweating otherwise known as hyperhidrosis.
  • A slow response to questions or bradyphrenia.
  • Dry skin on the scalp and face or a condition known as seborrhea.
  • Monotonous slurred speech.
  • Choking coughing or drooling due to dysphagia or difficulty in swallowing.
  • Many psychosocial symptoms can also be seen in parkinsonian patients such as anxiety and depression.
  • Sexual dysfunction.
  • Fatigue and disturbed sleep pattern.
  • Short term memory and visio-spacial function impairment.
  • Finally, a third of Parkinson’s sufferers will develop senile dementia which can itself lead to disorientation, impaired memory and judgment.

Many of the secondary complications of the disease can lead to death for example through other disorders such as pneumonia, urinary tract infections, pressure sores septicaemia and stroke.

The videos below show some of the classical symptoms of Parkinson's Disease. The videos are courtesy of users adaminvivodata and ParkinsonCA  respectively on YouTube1 and YouTube2.