10 Signs of Parkinson's Disease

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Parkinson's disease creeps up slowly, starting with mild symptoms that are easy to ignore at first. What follows are three cardinal features of the disorder (#1 through #3 below) that doctors look for, along with seven related signs (#4 through #10) that could be additional evidence of the illness.

If you notice these kinds of changes either in yourself or a loved one, consider seeking an opinion from a neurologist who specializes in movement disorders. Parkinson's disease can be tricky to identify, and not every patient will have all the possible symptoms. So a careful clinical examination by an expert is crucial.

According to widely used guidelines from the United Kingdom Parkinson's Disease Society Brain Bank, the first indicators of a Parkinson's diagnosis are sign #1 and at least one of signs #2 through #4.

Cardinal signs

1. He or she moves very slowly and seems clumsier. It takes longer than usual to button a shirt, make a phone call, or do any task that requires hand coordination -- and there's no other obvious explanation for it. This slowness of movement is known as bradykinesia. As the disease progresses, Parkinson's disease patients may find themselves momentarily "freezing" like a statue while walking or turning, unable to take the next step.

2. His or her hand or leg shakes when in a resting position. About 70 to 80 percent of Parkinson's disease patients have a "resting tremor" in the hands, arms, legs, jaw, or face. The shakiness occurs when, say, the patient rests her hand relaxed in her lap, as opposed to when moving to pour a cup of tea. The trembling could make it look as if she's rolling a pill between her thumb and forefinger.

If your loved one's hand is shaking while engaged -- holding a cup or writing with a pen, for example -- she may instead have what's called an "essential tremor," not Parkinson's disease.

3. He or she complains about feeling stiff or sore. Rigidity of the muscles in the arms, legs, and body makes it harder to move. Getting out of bed in the morning, or standing up from a chair, can be difficult. Patients with Parkinson's disease make fewer spontaneous body gestures and lose facial expressiveness. When flexing a bicep and then straightening the arm out, there may be a jerkiness to the motion, as if the arm is catching on a cogwheel.

More signs of Parkinson's disease

Related signs

4. He or she has been tripping or is unsteady on the feet. Another typical clue of Parkinson's disease is that patients have poor balance and tend to fall over, sometimes suddenly and for no apparent reason. They also tend to take small, shuffling steps. One major caveat, though: Changes in balance and gait tend to emerge as the disease progresses, not in the first couple of years. If your loved one is experiencing these kinds of troubles with few or no other Parkinson's signs, it probably indicates a different diagnosis.

5. The problems start on one side of the body. Whether it's a trembling pinky finger or a strange stiffness in the foot, the motor symptoms of Parkinson's disease almost always affect just one side at first. Later, sometimes after many years, they spread to the other side.

6. His or her handwriting has changed. One of the first oddities that many Parkinson's disease patients notice is that their handwriting has become smaller and cramped -- an early hint of motor difficulties.

7. He or she seems sad and low on energy. Parkinson's patients commonly develop depression before showing problems with movement. Experts believe the mood disorder is part of Parkinson's disease itself, not simply a reaction to having the illness.

8. When he or she walks, one arm doesn't swing as much as the other. In addition to moving slowly, Parkinson's patients typically move less overall. For example, they may swing their arms less often than normal (usually on one side, at first). They also blink less and swallow less.

9. He or she doesn't notice odors. Very early on, people with Parkinson's disease often lose their sense of smell because the neurodegenerative process affects the olfactory system. However, a reduced sensitivity to smells can also result from other causes.

10. His or her speech is harder to hear and understand. Parkinson's disease can make the voice softer, muffled, and slurred.


6 months ago, said...

Upon waking is when the tremors are the worst. Hands, head, jaw, arms. I've also experienced my arm jerking involuntarily and teeth chattering. I have had balance issues for years but they seem worse. I will be standing still when suddenly I feel like I am teetering on a balance beam. I have depression, extreme fatigue, confusion when waking. I don't know who to see or tell about my concerns


over 1 year ago, said...

I also have trouble with my eyesight.I have my wonderful wife that takes care of me.Sign my checks and helps me read my mail.I am also a diabetic like her. So its hard fighting two disease. Rich


over 3 years ago, said...

I have many symptoms but my Dr. says I don't have Parkinsons.


almost 5 years ago, said...

Dear Leanderjuel, I'm taking your comments to my neurologist next month and my internist in Jan. So much to learn. I fought taking Sertraline,Sim vastatin,Losartan,Lodipin,Gabapentin--and was told if I didn't take these, my doctor would no longer be my doctor (not all of them, but the cholesterol med--I just questioned the necessity of the others) I have CFS, COPD, hi blood pressure and cholesterol thus all these meds. I so appreciate more learned people taking the time to share their experience and knowledge. Thank you ever so much.


almost 5 years ago, said...

I'm being tested in Dec for tremors that I'm hoping fall under the "essential tremor" category. So appreciate such informative articles. Thank you very much.


about 5 years ago, said...

my mother had parkinson.s .disese..it was hard for waik to places. .....thank you for know about the disese.


about 5 years ago, said...

Hello vlo, Thank you very much for your comment. I'm very sorry to hear about the trouble you've been having lately, that must be hard on you. If you'd like, you can post your question in our Ask & Answer section, here: ( http://www.caring.com/ask ). Take care -- Emily | Community Manager


about 5 years ago, said...

my spouse has advanced Parkinson's, I know it is a struggle every day..that being said, there are days when he becomes mean, abusive, belligerent,rude,and in denial he is doing this, he patten answer is..."YOU never do anything wrong" "It was all YOUR fault" "Your the one who caused this!" Is this common in late stages or is there something else going on here? When he goes to his doctor appointments he acts fine so I get not input from him, I dont know what to do?


about 5 years ago, said...

Please allow me to vent a little. When I was 1st diagnosed w/Parkinson's I was already very depressed & had been for years. I had been having resting tremors for years much to my wife's dismay. (I am only 15 years younger than her dad but looked older) I fell once and had 27 stitches in my face, so no more walking the dog outside. Then fell in the kitchen and broke my shin bone, a compound fracture of both bones. Surgery etc. Then I decided I would hit this head on. I may not get better but I could try to be happier. I could and have learned to project my voice. I have to make an effort but I can do it. I do the balance exercises and they work, I still fall but not as much. I walk an average of 2 miles a day as briskly as I can. I lift light weights. I eat a strict diet. I take vitamin B12 shots. I spend about 6 hours a day reading researching, praying, meditating, stress reduction exercises and much more. Now my VA Dr (one of 4 who made this diagnoses) says, "You must never have had Parkinson's because the symptoms never get better and yours have. So no Agent Orange compensation for you!" Am I angry? You have got to be kidding! Will I quit doing what I'm doing? You've got to be kidding! All the VA can offer is money. I should be compensated but if it is a choice between a better life or compensation, keep your money!


about 5 years ago, said...

the 10 signs of parkinsons. Lets me know what to look for


over 5 years ago, said...

Inaccurate. Cleveland Clinic Parkinson's specialists will NOT give a firm diagnosis of Parkinson's without THREE of the four symptom groups. TWO of the four is enough to say you MIGHT have it, but also not enough to say you DO (which means you might NOT).


over 5 years ago, said...

very inaccurate if you suggest that symptons come in that order always!


over 5 years ago, said...

Very informative. Keep us posted.Thanks a lot


over 5 years ago, said...

May have the beginning.


over 5 years ago, said...

Hi 11-dillybars­, Thanks very much for your comment. I believe the symptom you are referring to is sundown syndrome. To learn more about sundown syndrome, visit this article: ( http://www.caring.com/articles/sundown-syndrome ). You may also find this Ask & Answer page useful as well: ( http://www.caring.com/questions/dealing-with-sundowning ). I hope that helps. Take care! -- Emily | Community Manager


over 5 years ago, said...

It really did clear some issues I had been having. What is the part of Alzhimers that has something to do with the dark ? or just of being afraid of the night? Can anyone tell me?


over 5 years ago, said...

B"H Any person who takes anti-depressants is at risk of Parkinson's Disease. Anti-depressants which raise the serotonin level cause a reduction in dopamine. Lack of dopamine is the main cause of PD.


over 5 years ago, said...

A description of the symptoms was most helpful


over 5 years ago, said...

all of this helped me. My Dad had Parkinsens Disease. Thank you


over 5 years ago, said...

Thank you for addressing this particular disease. My husbands mother had it many years before passing away. My husband has been having tremors in his face and others occaisionally but specifically on his face while relaxing. I was surprised to see he has many of these symptoms mentioned. I have suspected it for a long time. When I mentioned it to the doctors I have not had much response nor concern. Now I am armed with more info that I can take to the doctor. I never knew what exactly the symptoms were except for the obvious ones that appear as the disease progresses. This has been a tremendous help to me.


over 5 years ago, said...

Other's comments were very helpful for me. Thank you.


over 5 years ago, said...

All of it. Excellent presentation. Nathan in Guatemala.


over 5 years ago, said...

This article is helpful to me,as my husband was recently diagnosed with beginning stages of Parkinson's Disease. We know very little about this disease and are interested in any articles or advice concerning it.


over 5 years ago, said...

Dad had Parkinson's for 16 yr. The very first symptom the Doc noticed was an extreme amount of dandruff, with very large pieces of skin falling.


over 5 years ago, said...

Interesting. My boyfriend seems to have several of these symptoms. Many times when I am speaking to him on the phone I ask him to repeat his words, he speaks very softly and appears to slur, especially if he's been sleeping. Also he takes a long time to get up when he takes a nap...he says his legs won't move, I thought he was just joking. He trips sometimes but I thought it was because he has big feet. He also complains a lot of not having any energy or suddenly losing energy, he constantly drinks caffenated beverages trying to perk up


over 5 years ago, said...

Hi anonymous, Thank you for your question. We write our own content and do not get paid to write articles by pharmaceutical companies. We keep a strict separation between advertising and content -- none of the articles or other content on Caring.com is influenced in any way by our advertisers, and wherever an ad appears, it's clearly labeled as an ad. If you'd like to learn more about how we make money, you can view our "How We Make Money" page, here: (http://www.caring.com/about/how-we-make-money.html). I hope that clears things up for you! If you have any further questions, feel free to contact us at moderators@caring.com. Take care! -- Emily | Community Manager