What are Parkinson’s symptoms?

Symptoms in Parkinson’s affects everyone differently, but the three classic symptoms of Parkinson’s are tremor, stiffness and slowness of movement plus impaired balance or difficulty walking or standing (postural instability).^1-3

These symptoms may be mild in the early stages of Parkinson’s and may go unnoticed. Often they start on one side, before getting worse on that side and eventually involving both sides of the body.^1-3

Motor

Motor symptoms are those affecting movement. The most common motor symptoms are tremor, muscle rigidity and slowness of movement.

Alongside motor symptoms, people with Parkinson’s may also experience, motor fluctuations and non-motor symptoms, which may be troublesome.^1-3

Motor fluctuations can occur as the benefit you get from your Parkinson’s medicine – levodopa – declines. You may notice that your motor symptoms are no longer as well controlled and fluctuate in severity during the day. These may appear as ‘wearing off’ of the effect of your levodopa medication before you take your next dose.³

Non-motor

Non-motor symptoms may be less obvious or may happen gradually, so you don’t always notice them. Non-motor symptoms include a range of other symptoms such as those affecting your mood, your bladder or bowel habits, your energy levels and so on.

Not everyone will experience the same non-motor symptoms or be bothered by them. Non-motor symptoms in Parkinson’s are common and can be more troublesome for patients than motor symptoms.^1-3

If you, your family or carer notices a change in you that is different from normal, or you are concerned, speak with your doctor or nurse. By recognising the many motor and non-motor symptoms associated with Parkinson’s and discussing these openly and honestly, you can manage your Parkinson’s effectively and maintain your independence and quality of life.

Motor symptoms

Tremor

Tremor is one of the three classical symptoms of Parkinson’s. It appears along with stiffness and slowness of movement but not everyone will develop a tremor. Tremor is an involuntary movement. Rest tremor is common and occurs when your body is relaxed, you may rub your thumb and forefinger together back and forth – this is called "pill-rolling" rest tremor. You may also have action tremor, that occurs when trying to do something like hold a magazine.^1-3

Stiffness

Muscle stiffness, or rigidity, may occur in any part of your body and can make movement difficult and painful. It is one of the three classical symptoms of Parkinson’s and appears along with tremor and slowness of movement.^1-3

Slow movement

A key symptom of Parkinson’s is slowness of movement, also called bradykinesia. You might notice it as a shuffling style of walking, or difficulty getting out of a chair. It often makes simple tasks difficult or more time consuming.^1-3

Postural instability

These symptoms are often accompanied by postural instability, where your posture is changed and you have problems with balance, walking or standing.³

Restless legs

During the evening or when you are asleep you may experience an overwhelming urge to move your legs and you may experience tingling, burning or itching sensation. This is called restless legs and it may keep you awake and cause tiredness during the day or increased sleepiness. Talk to your doctor or nurse as it can be treated with lifestyle or dietary changes or medications.^1-3

Drooling

In Parkinson's drooling or hypersalivation is very common. Parkinson's affects automatic reflex actions like swallowing, which would normally control the amount of saliva in your mouth. Referral to a speech and language therapist can help to give you ways to manage swallowing, whilst referral to a physiotherapist may improve your posture which can help. Also, speak with your doctor who can adjust your Parkinson’s medications or prescribe medicines to help with saliva production.³

Non-motor symptoms

Anxiety

Anxiety affects 2 out of 5 people with Parkinson’s¹ and may be worse if you are experiencing problems with medication ‘wearing off’ or motor fluctuations.³ It is not related to the progression of Parkinson’s disease. There are some forms of anxiety: generalised anxiety disorder, where you experience an excessive and uncontrollable need to worry most of the time; panic attacks, which are periods of sudden, intense feeling of fear leading to a racing heart, sweating and shortness of breath; and phobia, where you feel frightened of something that would no usually make other people feel scared.³

Constipation

Constipation is the most common complaint in Parkinson’s of the gastrointestinal system and may lead to a feeling of fullness, even after eating small amounts, and a difficulty in passing stools. If you experience a frequent feeling of fullness or vomiting speak with your doctor. If you experience constipation or have difficulty in going to the toilet, the increase of fibre in your diet and also in the amount of fluids that you drink.^1,3

Cognitive changes

If you notice signs of forgetfulness or problems with thinking, speak with your doctor.

Dementia

In some people with Parkinson’s as disease progresses problems with memory loss or difficulties with thinking may occur. These symptoms may be a signal for stress, depression or some physical illnesses or may be a sign of dementia. Dementia in people with Parkinson’s requires careful diagnosis to distinguish it from another form of dementia called Dementia with Lewy Bodies (DLB).^1,2

If you notice signs of forgetfulness or problems with thinking, speak with your doctor.

Apathy

Apathy is a state of indifference, characterised by a lack of emotion, motivation or interest. People with depression commonly feel sad and low while a person with apathy shows a lack of emotion, either happy or sad.³

Depression

Depression affects around 50% of people with Parkinson’s1 and can be treated. Self-help treatment includes:

• Regular exercise

• Relaxation

• Accept help when you need it

Therapeutic treatments and medications are available and can treat depression so speak with your doctor or nurse.³

Fatigue

Fatigue, a sense of tiredness that does not improve with rest, is common in Parkinson’s and can occur in any patient at any time. At least one-third of people with Parkinson’s are affected.³ The reasons for fatigue are poorly understood and this symptom can be easily overlooked so it is important to mention this to your doctor or nurse.^1-3

Sexual problems

People with Parkinson’s may experience problems with sex and intimacy including reduced sex drive, erectile dysfunction, vaginal dryness, inability to reach orgasm or, in a few cases, an excessive interest in sexual activity or an extremely frequent or suddenly increased libido (hypersexuality) which may arise from medications used to treat Parkinson’s disease. If you are worried about problems with sex or intimacy speak to a sex therapist, or to your doctor.⁴

Urinary problems

People with Parkinson’s may experience urge incontinence where you have an urgent need to urinate without warning and nocturia where you may need to get up multiple times in the night to urinate. If affected by urinary problems, speak with your doctor.¹

Hallucinations & delusions

Hallucinations can be a side effect of Parkinson’s medications and may affect about 50% of people with Parkinson’s. They are a perception of something that does not actually exist (it involves seeing, hearing or tasting). Delusions, occures when you have illogical or irrational thinking. If you experience hallucinations or delusions for the first time, or they get worse, speak with your doctor or specialist nurse as soon as possible.^1-3

Low blood pressure

Low blood pressure in Parkinson’s often occurs when you stand and you feel light-headed. This is called orthostatic or postural hypotension. It can be a result of your Parkinson’s disease medication (particularly with levodopa or dopamine agonists) as well as a range of other medications.^2,3

Pain

Pain is a common symptom of Parkinson’s and is most often felt in muscles and joints but can also appear as muscle cramps, involuntary muscle contractions (called dystonia) or involuntary movement (called dyskinesia) which may be related to levodopa medication. If you experience pain, speak with your doctor or nurse as they can recommend pain relieving drugs (analgesics) – or refer you to another doctor specialising in pain management.^1-3

Skin problems

People with Parkinson’s disease may experience skin problems including oily skin (known as seborrhoea) particularly on the face and scalp, that means it becomes greasy and shiny. You may also experience a condition called seborrheic dermatitis (skin becomes oily, red, flaky and itchy) which is common in Parkinson’s disease. If you have oily skin or experience seborrheic dermatitis talk to a pharmacist or your doctor that will be able to advise on suitable products.³

Sweating

Excessive sweating may occur in Parkinson’s and can occur as medications start to ‘wear off’ or during the ON time if you have dyskinesia. If sweating becomes troublesome speak with your doctor, nurse, or pharmacist. Some people with Parkinson’s may not sweat enough, which may be a side effect of some medicines. Sweating is important to regulate your body temperature. If this is you, speak with your doctor or specialist nurse as a reduced ability to sweat may cause you to overheat.^2,3

Vision problems

People with Parkinson’s may experience range of eye problems including difficulty moving the eyes, blurred or double vision and dry eyes. Difficulty seeing properly can increase the risk of falling or safety issues with driving.6 If you experience blurred vision or abnormalities of blinking for example, speak with your doctor who can explore treatment options such as artificial tear solutions administered as eye drops.^1,2

Impulsive behaviour

Medications used to treat Parkinson’s disease can cause impulsive behaviour as a side effect. Impulsive behaviours may include unusual, excessive, or increased shopping, sexual behaviour, gambling, medication abuse or binge eating. Any appearance of impulsive behaviour should be discussed with your doctor as soon as possible.^1-3

Dry mouth

Dry mouth may be a side effect of your medicines, so if this affects you, speak with you doctor or specialist nurse as they may be able to change your medicines or change the doses. You can also suck on hard candy/sweets to help your mouth produce more saliva. Speak with your pharmacist or dentist who may be able to advise you about options to help.⁵

Swallowing problems

Problems with swallowing, known as dysphagia, may develop slowly over time and include drooling, food sticking in your throat, choking, and coughing. If this affects you, you may not eat as much as you should to avoid the issue. Talk to your doctor or specialist nurse as soon as you notice a problem as they can refer you to other specialists, such as speech and language therapists, who can help.^1-3

Forgetfulness/thinking problems

Many people with Parkinson’s may experience mild memory or thinking problems (for example slowness of thought). These symptoms do not mean you have dementia and may be caused by other reasons such as lack of sleep or anxiety and depression. It is important to speak with your doctor or specialist nurse if you experience symptoms of memory impairment or problems with thinking.^1-3

Sleep problems

You may experience sleep problems such as insomnia where you can’t get to sleep or stay asleep. As insomnia can be caused by some medications, speak with your doctor or specialist nurse if this is troublesome. You may also experience nocturia where you need to get up multiple times in the night to urinate. Another condition associated with Parkinson’s is rapid eye movement disorder which may cause you have vivid dreams or talking and moving when you are asleep. If you experience these symptoms speak with your doctor or specialist nurse.^1-3

Loss of sense of smell

Most people with Parkinson’s will notice some reduction in their ability to smell, and for some the sense of smell is lost altogether (this is called hyposmia) which can change the way you can taste food or detect odours. Although there is currently no known treatment to improve the sense of smell, you should let tell your doctor or nurse if you notice this symptom.^1-3

More information can be found at:

Parkinson’s Europe: www.parkinsonseurope.org

Parkinson's Foundation www.parkinsons.org

Common Questions

Symptoms in Parkinson’s affects everyone differently, but the three classic symptoms of Parkinson’s are tremor, stiffness and slowness of movement plus impaired balance or difficulty walking or standing (postural instability).^1-3

Other Common Questions

Common Questions

What are Parkinson’s symptoms?

Symptoms in Parkinson’s affects everyone differently, but the three classic symptoms of Parkinson’s are tremor, stiffness and slowness of movement plus impaired balance or difficulty walking or standing (postural instability).1-3

Other Common Questions

Can anyone get Parkinson's?

Can Parkinson's be cured?

Can Parkinson's be reversed?

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Symptoms in Parkinson’s affects everyone differently, but the three classic symptoms of Parkinson’s are tremor, stiffness and slowness of movement plus impaired balance or difficulty walking or standing (postural instability).^1-3