The nature and severity of symptoms can vary considerably from one person to another. In the early stage, signs of Parkinson’s disease (PD) for being mild can be overlooked. During the initial phase of the disease, symptoms are usually observed on one side of the patient’s body. Even after symptoms begin to affect both sides, they generally remain dominant on the initially affected side. Most common signs of PD, include:
1. Tremor
Tremor is the most visible sign of the disease. However, in few cases, people with PD will not observe tremors. In the early stage, individual experiences a slight tremor in the hand or foot, on one side of the body. However, the most common onset is tremor in one finger. A shaking movement usually appears when the patient’s muscles are at rest or relaxed and as a disease progresses, he experiences intense trembling when the fingers or hand are folded in the lap, or when the limb is relaxed. Such tremors cease the patient whenever he tries to perform an action. As severity of PD symptoms vary from one person to another, some people are able to control a hand tremor by maintaining a flexed grip.
2. Bradykinesia
One of the most common Parkinson’s disease symptoms, Bradykinesia is primarily characterized by the slowness of movement, mask-like expression of the face and reduced blink rate of the eyes. Patients’ face may appear less expressive due to decreased unconscious facial movements.
Muscle weakness, tremors and rigidity contribute to aggravate this movement disorder, which results in making simple tasks such as buttoning a shirt difficult and time-consuming. Other signs of Bradykinesia include having trouble in turning over, finding getting out of a chair difficult and small handwriting. Due to Bradykinesia, a patient has to drag his feet in order to walk.
3. Rigidity
While not all people with PD experience stiffness in muscles, it is one of the most common symptoms of the disease alongside tremors and Bradykinesia. Patients with PD may experience muscle stiffness in any part of a body, which can limit their range of motion and cause pain. People with muscle rigidity face difficulty in swinging their arms while walking as their muscles are too stiff and tight.
4. Postural Instability
People with PD frequently complain about impaired posture and balance. As a result of the disease, their posture becomes stooped and they face difficulty in standing up straight. As PD mainly affects the motor system of an individual, posture changes occur without the brains’ automatic reminders to stand up straight. Other PD symptoms like muscle stiffness, too, can negatively affect posture.
5. Slurry Speech
Apart from affecting movement in other parts of the body, PD also disturbs the muscles that are used in speaking. The disease can affect an individual’s voice, making it difficult for him to speak softly or clearly. Other Bradykinesia symptoms of mask-like face further makes it harder for a patient to communicate the emotions, which can be misinterpreted as patient’s lack of interest in the conversation. In few cases, people with PD struggle to recall words, as a result they speak slowly. Just like all other PD symptoms, these changes in speech behavior vary from person to person.
6. Freezing
Many people with PD experience inability to move. Though temporary, Freezing can occur at anytime, anywhere. Some people are more likely to have more freezing episodes than others, which is why they are at a much higher risk of falling while turning or changing directions. The cause of freezing, which is unpredictable, is unknown.
7. Drooling and Swallowing Issues
Some people with PD produce too much or too little saliva, which makes it difficult for them to eat and swallow. Food blockage in the airway is commonly linked with the problem. These difficulties lead to fear of choking and hence can have a negative impact on an individual’s quality of life.
8. Dystonia
Dystonia affects nearly 40% people living with the disease and is more common in Parkinson’s fighters diagnosed at a younger age (under 40). While the exact cause hasn’t been identified yet, the dopamine deficiency in Parkinson’s is thought to be a potential reason behind the symptom. Dystonia in Parkinson’s usually begins in one body region (usually the neck, face, vocal cords, arm, or leg) and then may spread to other parts of the body.
Characterized by involuntary, repetitive twisting and muscle contractions, the symptom contributes to deteriorating movement and posture in Parkinson’s fighters.
9. Sleeping Disorder
Due to physiological changes in the brain, some people experience sleeping disorder even before PD is diagnosed. As disease prevails, many patient face trouble sleeping throughout the night as several symptoms like rigidity or tremor make them unconformable to fall asleep.
10. Constipation
Due to the ill-functioning of the autonomic nervous system, which regulates smooth muscle activity, constipation may occur in some patients. Many people with PD observe constipation before they notice most common motor symptoms like tremor or rigidity in muscles.
11. Loss of Smell
Loss of smell (degree varies among different people) can be an early clue for the PD development in an individual. Not all, but the majority of patients notice a reduced sense of smell at the early stage of the disease. Due to dopamine deficit, various parts of the nervous system and brain are affected, including the olfactory bulb, which is responsible for controlling the sense of smell in an individual.
12. Dizziness or Fainting
About 15-50% people with PD complain about feeling dizzy on a regular basis. Some PD medications worsen the dizziness as they can make blood pressure drop suddenly. In Parkinson’s, the nervous system is not able to release norepinephrine — a chemical that sends the signal to blood vessels to tighten or constrict to raise blood pressure so that it reaches back to the brain. Hence, the reduced blood flow to the brain leads to dizziness and occasional fainting in PD patients.
13. Depression and Anxiety
Mood swings and disorders such as anxiety and depression are clinical and non-motor symptoms of PD. As per an estimate, about 50% people experience depression and anxiety during the course of the disease. However, these mood disorders are not linked to Parkinson’s progression as they can be prevalent before diagnosis or develop much later on. While some PD patients experience anxiety and depression together, some may be diagnosed with either one of the conditions.