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Symptoms of Parkinson's Disease

Primary symptoms of Parkinson's

Symptoms of Parkinson’s disease (PD) can be divided into two groups: motor (movement) and non-motor (non-movement) and vary from person-to-person.

As the disease progresses, people may experience impairment of the autonomic nervous system (non-motor or non-movement), including difficulty with sleep and speech, depression, low-blood pressure and constipation.

Some of the most common motor (movement) symptoms of Parkinson's disease include:

  • muscle rigidity - stiffness when the arm, leg, or neck is moved
  • resting tremor - tremor (involuntary movement from contracting muscles) that is most prominent at rest
  • bradykinesia - slowness in initiating movement
  • postural instability - poor posture and balance that may cause falls; gait or balance problems

Muscle Rigidity:

Rigidity is felt as a stiffness or tightness in the arms, legs, neck or trunk of the body. It is not uncommon for a patient to be evaluated and treated for arthritis in a shoulder prior to diagnosis of PD. This symptom responds well to anti-Parkinson's medications.

Resting Tremors:

The tremor associated with PD is characteristic in that it occurs at rest rather than when the limb is being used and it is fairly slow occurring at a rate of about five times per second. It usually starts in one arm and moves to the other. Sometimes the legs and occasionally the jaw can be effected. The tremor can be reduced or eliminated by moving the limb in a purposeful way. For this reason, tremor is often not functionally limiting and typically responds well to anti-Parkinson's medications.

Bradykinesia (Slowness of Movement):

Slowness of movement is one of the main symptoms for which treatment is sought as it limits an individual’s ability to perform everyday tasks. Handwriting is characteristically small and this change is often one of the first signs noted by some patients. This symptom responds well to anti-Parkinson's medications.

Postural Instability (Walking and Balance Difficulties):

One of the first signs of PD is a decrease in the natural swing of an arm while walking. As the disease progresses, this involves both arms and it may impact a person’s ability to take large steps so that a shuffling gait develops.

As the disease advances, individuals may experience "freezing" episodes when they feel like their feet are glued to the floor and taking any steps becomes very difficult. Also, a person’s balance may be effected. This may be caused by a reduced ability to make corrective adjustments to prevent falling. When these later symptoms develop, physical therapy and the use of devices such as canes and walkers are recommended. Unfortunately, balance problems do not respond well to anti-Parkinson's medications.

Other symptoms of Parkinson's Disease:

Symptoms of PD vary from patient to patient. They may appear slowly and in no particular order. Early symptoms may be subtle and may progress over many years before reaching a point where they interfere with normal daily activities. Examples of common non-movement (non-motor) symptoms include:

  • Constipation
  • Orthostatic hypotension
  • Sexual dysfunction
  • Excessive salivation
  • Medication-related motor complications
  • Depression/anxiety
  • Cognitive Impairment
  • Hallucinations/delusions
  • Behavioral disturbances
  • Sleep symptoms

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Maryland Patients

To request an appointment, please contact the Johns Hopkins Parkinson’s Disease and Movement Disorders Center at 410-502-0133.
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Adult Neurology: 410-955-9441
Pediatric Neurology: 410-955-4259
Adult Neurosurgery: 410-955-6406
Pediatric Neurosurgery: 410-955-7337


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