From the Guidelines
Parkinson's disease is characterized by a distinct set of clinical signs, including resting tremor, rigidity, bradykinesia, and postural instability, which result from the progressive loss of dopaminergic neurons in the substantia nigra, leading to dopamine deficiency in the basal ganglia 1. The primary signs of Parkinson's disease include:
- Resting tremor, which typically begins in one hand and resembles a pill-rolling motion
- Rigidity, felt as increased resistance during passive movement of limbs
- Bradykinesia, which is slowness of movement affecting daily activities
- Postural instability, leading to balance problems and falls Other common signs include:
- A shuffling gait with reduced arm swing
- Stooped posture
- Micrographia (small handwriting)
- Hypomimia (reduced facial expressions or "masked face")
- Hypophonia (soft speech)
- Difficulty with fine motor tasks As the disease progresses, patients may develop freezing of gait, where they feel temporarily unable to move forward 1. Non-motor signs are also important and include:
- Sleep disturbances
- Constipation
- Depression
- Anxiety
- Cognitive changes
- Olfactory dysfunction (reduced sense of smell) These signs can vary significantly between patients, with some experiencing tremor as the predominant feature while others may have more pronounced rigidity or bradykinesia 1. Early recognition of these signs is crucial for timely diagnosis and management of Parkinson's disease, as patients are at increased risk of malnutrition and weight loss, and nutritional status should be monitored routinely throughout the natural history of the disease 1.
From the Research
Clinical Signs of Parkinson's Disease
The clinical signs of Parkinson's disease are characterized by several key features, including:
- Bradykinesia (slowness of movement) 2, 3, 4
- Rigidity (stiffness of the muscles) 2, 3, 4
- Tremor (shaking or trembling of the limbs) 2, 3, 5, 6, 4
- Postural instability (imbalance or loss of balance) 2, 3, 4
Types of Tremor
There are several types of tremor that can occur in Parkinson's disease, including:
- Rest tremor (tremor that occurs when the limb is at rest) 5, 6
- Postural tremor (tremor that occurs when the limb is held in a fixed position) 6
- Kinetic tremor (tremor that occurs during movement) 6
Other Clinical Features
Other clinical features of Parkinson's disease may include:
- Dissymmetry (asymmetry of the symptoms) 4
- Shuffling gait (a gait characterized by small, quick steps) 4
- Camptocormia (a stooped or bent posture) 4
- Micrographia (small handwriting) 4
- Aphasia (difficulty speaking) 4
- Hypophonia (soft or weak voice) 4
- Dysphagia (difficulty swallowing) 4
- Hypomimia (reduced facial expressions) 4
- Akathisia (restlessness or agitation) 4
- Insomnia (difficulty sleeping) 4
- Somnolence (excessive sleepiness) 4
- Hyposmia (reduced sense of smell) 4
- Neck pain 4
Non-Motor Symptoms
Non-motor symptoms of Parkinson's disease may include: