Signs and Symptoms

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. 

 

Motor Symptoms
The three classic motor symptoms of PD are:

  • Stiffness (rigidity): stiffness and inflexibility of the limbs, neck and trunk. Muscles normally stretch when they move, and then relax when they are at rest.  With rigidity, there can be a tightness of the neck, shoulder and leg which can reduce the range of motion.

  • 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 — also may occur. These can happen any time in the course of Parkinson's, but are more likely as the disease advances.

 

Non-motor Symptoms
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:

  • 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

  • Sweating problems: excessive perspiration, even when not hot or anxious

  • Urine problems: frequent urination, involuntary loss of urine (incontinence) or difficulty emptying the bladder (weak stream)

 

Non-motor Symptoms: 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

 

Non-motor Symptoms: 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 may occur in some people

 

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.