tremorEach person will have different symptoms and different changes or rate of progression over time. Listen to the presentation on the left to learn how symptoms progress over time.

Primary and early movement problems can include:

  • Rest tremor- rhythmic shaking in your arms, legs mouth or chin. This tremor is typically worse when you are relaxing and resting your arm or leg. 
  • Bradykinesia- slowness of movement
  • Rigidity- stiffness in arms or legs
  • Walking and Posture-stooped posture, decreaed arm swing (one side in the beginning), leg drgagging or shuffling. Balance  problems are not experienced until later stages of the disease.

In addition, early symptoms can include masked like face or loss of facial expression, small handwriting termed micrographia, and decreased arm swing. Some people notice a feeling of heaviness in the legs, dragging of one side or cramping in certain muscles. Speech can become softer and swallowing can be affected later in the disease.

Movement problems in advancing disease include:

Posture (1)Flexed Posture

Falls from walking and balance problems

  • Freezing of Gait-- Noted  with beginning or initiating movements often
     described as a sense of feet being “glued to the floor.”  Freezing occurs:
  • With first few steps
  • During turns or change in direction   
  • At thresholds and in crowded environments or cluttered rooms

Other motor symptoms include: 

  • Speech- Soft, low volume, slurred, stuttering and speech that fades  
  • Swallowing- Drooling, cough, and swallowing problem (usually for liquids before solid food)
  • Dystonia is a symptom that can cause muscle spasm, pulling and pain. Dystonia can occur as an off symptom (i,e, early morning foot dystonia) or as a form of dyskinesia at peak dose ( see  Moderate Stage PD.)
  • Dyskinesia- uncontrolled involuntary movements more frequently noted during peak medicine effect
Nonmotor symptoms can occur and are reviewed in the nonmotor section.
The symptoms checklist located in My Medical Chart is a useful summary you can use to help your medical or hospital team personalize your care.

Monique L. Giroux, MDMonique L. Giroux, MD
Guest Blogger, Former Medical Director of NWPF