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Symptoms of Parkinson’s Disease

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Parkinson’s disease is characterised by a series of motor symptoms. The most common are:

Person with cane and motor retardation

Motor delay (bradykinesia). This is the most common and that which defines the disease. It is evident in repetitive and automated tasks (beating an egg, walking) with manual loss (fastening buttons, changes in writing such as smaller letters).

Person with a cane and trembling

Tremor. It is present at rest typically, although it can also be while active. It usually starts in one part of the body (either in the hand or in the foot) before becoming bilateral. Around 40% of patients never have it throughout the disease.

Person lying stiffly on the ground

Muscle rigidity. With symptoms associated with joint or tendon pain (tendinitis is very characteristic, for example, in the back).

Person walking with difficulty or less legs sensibility

Changes in gait. It is not usually a serious or disabling problem until advanced phases. However, many patients may refer to an early form in which they experiment a more dragging or slower gait compared to other people.

In the last few decades it has been seen that these characteristic motor symptoms can be preceded by other symptoms called prodromic. Some of these symptoms are non-motor, such as:

Decreased sense of smell or hisposmia

Decrease in acute sense of smell (hyposmia).

Woman with bowel problems by the toilet

Constipation.

Senior person in bed with recurring dreams

Sleep disorders. REM sleep disorder (vivid nightmares with vigorous movements and vocalisations during sleep), insomnia, and excessive drowsiness.

Disheveled person looking in the mirror

Apathy. Lack of motivation and of interest.

Woman with generalised pain

Pain. Besides the rigidity itself, etc.

Sometimes, it is said that these symptoms are risk factors, but they are not. They are initial symptoms that precede the development of the disease (prodromic symptoms), together with other motor symptoms, like mild-activity tremor that may be classified as non-Parkinson tremor if there is no tremor at rest, or other symptoms typical of the disease.

The non-motor symptoms may not only precede the motor disease, but in some cases during its course they can be as severe and disabling as the motor symptoms, such as dementia or autonomous nervous system dysfunction (dysautonomia).

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Signs

Person with cane and motor retardation

Motor delay (bradykinesia). Gradual decrease in the range and/or speed of repetitive movements like the opening and closing of the hand, as well as the speed of voluntary movements and limitation of their extension (hypokinesia) with poorness of general movement.

Person with a cane and trembling

Tremor at rest. Usually in a relatively low frequency range (4-6 Hz) and a variable width that affects one side of the body in an isolated form initially, and predominantly during the course of the disease.

Person lying stiffly on the ground

Rigidity. It can be a diagnostic sign, even when the patient has not noticed it symptomatically, and is detected by moving the joints of the patient.

Person walking with difficulty or less legs sensibility

Changes in gait. It can be demonstrated by short and dragged steps, with blocks or paralysis when walking in tight spaces or on turning round. The reduction in movement of one of the two arms when walking is also very characteristic.

Person with lack of facial expression or hypomimia

Lack of facial expression (hypomimia).

Poster with large and small letters

Decreased font size (micrograph).

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Substantiated information by:

Almudena Sánchez Gómez
Ana Cámara Lorenzo
Maria José Martí
Yaroslau Compta Hirnyj

Published: 8 July 2019
Updated: 14 November 2019

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.

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