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Home > Medical Reference > Encyclopedia (English)

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Parkinson's disease - Symptom

Alternative Names

Paralysis agitans; Shaking palsy

Symptoms:

The disorder may affect one or both sides of the body. How much function is lost can vary.

Symptoms may be mild at first. For instance, the patient may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.

Symptoms include:

  • Automatic movements (such as blinking) slow or stop
  • Constipation
  • Difficulty swallowing
  • Drooling
  • Impaired balance and walking
  • Lack of expression in the face (mask-like appearance)
  • Muscle aches and pains (myalgia)
  • Problems with movement
    • Difficulty starting or continuing movement, such as starting to walk or getting out of a chair
    • Loss of small or fine hand movements (writing may become small and difficult to read, and eating becomes harder)
    • Shuffling gait
    • Slowed movements
  • Rigid or stiff muscles (often beginning in the legs)
  • Shaking, tremors
    • Tremors usually occur in the limbs at rest, or when the arm or leg is held out
    • Tremors go away during movement
    • Over time, tremor can be seen in the head, lips, tongue, and feet
    • May be worse when tired, excited, or stressed
    • Finger-thumb rubbing (pill-rolling tremor) may be present
  • Slowed, quieter speech and monotone voice
  • Stooped position

Other symptoms:

Signs and tests:

The health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. The signs (tremor, change in muscle tone, problems walking, unsteady posture) become more clear as the illness progresses.

An examination may show:

  • Difficulty starting or finishing voluntary movements
  • Jerky, stiff movements
  • Muscle atrophy
  • Parkinson's tremors
  • Variation in heart rate

Reflexes should be normal.

Tests may be needed to rule out other disorders that cause similar symptoms.

  • Reviewed last on: 7/4/2009
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.

Miyasaki JM, Shannon K, Voon V, Ravina B, Kleiner-Fisman G, Anderson K, et al. Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson's disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:996-1002.

Pahwa R, Factor SA, Lyons KE, Ondo WG, Gronseth G, Bronte-Stewart H, et al. Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:983-995.

Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner WJ. Quality Standards Subcommittee of the American Academy of Neurology. Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006.66:968-975.

Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.

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