From the Guidelines
Parkinson's disease symptoms include tremors at rest, bradykinesia, muscle rigidity, and postural instability, which can significantly impact morbidity, mortality, and quality of life if left untreated or poorly managed. These symptoms result from the progressive loss of dopamine-producing neurons in the brain's substantia nigra, disrupting normal movement control pathways 1. Patients experience a range of motor symptoms, including:
- Tremors at rest, typically starting in one hand or limb
- Bradykinesia (slowness of movement)
- Muscle rigidity
- Postural instability leading to balance problems and falls
- Shuffling gait
- Stooped posture
- Reduced facial expressions (masked face)
- Small handwriting (micrographia)
- Voice changes such as soft or monotone speech
Non-motor symptoms are also prevalent, including:
- Sleep disturbances
- Constipation
- Depression
- Anxiety
- Cognitive changes
- Loss of smell Symptoms typically begin gradually on one side of the body before progressing to both sides 1. Early diagnosis allows for better symptom management through medications like levodopa, dopamine agonists, and other treatments that can significantly improve quality of life, though they don't halt disease progression 1. It is essential to monitor nutritional status in patients with Parkinson's disease, as they are at increased risk of malnutrition and weight loss, particularly those taking levodopa 1.
From the FDA Drug Label
Parkinson’s disease is a progressive, neurodegenerative disorder of the extrapyramidal nervous system affecting the mobility and control of the skeletal muscular system. Its characteristic features include resting tremor, rigidity, and bradykinetic movements. The symptoms of Parkinson's disease include:
From the Research
Motor Symptoms of Parkinson's Disease
- The primary motor symptoms of Parkinson's disease include bradykinesia, muscle rigidity, resting tremor, and postural instability 4
- Additional motor deficits may include gait disturbance, impaired handwriting, grip force and speech deficits 5
- Motor symptoms such as deficits of gait, speech, and handwriting have similar clinical profiles, neural substrates, and respond similarly to dopaminergic medication and deep brain stimulation (DBS) 5
- Other motor symptoms include resting tremor, cogwheel rigidity, extreme slowness of movement, shuffling gait, and impaired balance 6
Non-Motor Symptoms of Parkinson's Disease
- Non-motor symptoms include depression, hallucinations, and sleep disturbances that seriously affect quality of life 6
- Swallowing and speaking difficulties are also common non-motor symptoms 6
- Anxiety, depression, sleep, gastrointestinal and cognitive functions may be altered in Parkinson's disease 7
Treatment of Symptoms
- Carbidopa-levodopa is an effective initial treatment for motor symptoms of rigidity and resting tremors 6
- Treatments for non-motor symptoms include antidepressants, antipsychotics, and drugs for dementia 6
- A multidisciplinary approach to optimizing care can include physical and occupational therapy, speech therapy, and psychological therapy 6