What are the symptoms associated with Parkinson disease?

There are four cardinal symptoms. At least two of these symptoms must be present in order for a physician to suspect a diagnosis of Parkinson's disease.

Resting Tremor

  • Most recognized symptom
  • Seen initially in about 75% of persons with PD
  • Typically begins on one side
  • More noticeable at rest
  • Often presents as "pill rolling"
  • Increases with stress
  • Tremor can involve hands, arms, foot, leg, chin, jaw, or tongue


  • Involuntary increase in muscle tone resulting in continuous resistance
  • Tremor superimposed on the rigidity presents as a ratchet-like sensation known as "cog wheeling"
  • Rigidity underlies the stooped posture, forward flexed head, flexed knees and elbows


  • (Slowness of movement ) is the central, most significant movement disorder in PD
  • Inhibits all aspects of activities of daily living (ADL)
  • Secondary effects include decreased arm swing while walking & eye blink, facial masking, slowed chewing & swallowing

Postural Instability

  • Typically the last of the "cardinal" symptoms to appear
  • Not usually responsive to dopaminergic treatment
  • Appears to be a problem with the "righting reflex"

There are a number of secondary motor symptoms and non-motor features that are associated with Parkinson's disease also.

Some of the secondary motor symptoms include:

  • Dystonia
  • Fatigue
  • Impaired fine and gross motor coordination
  • Speech impairment
  • Swallowing difficulties
  • Micrographia

Some of the non-motor features include

  • Olfactory Dysfunction
  • Visual Dysfunction
  • Pain
  • Behavioral Dysfunction
  • Depression
  • Anxiety
  • Dementia
  • Sleep Disturbances
  • Respiratory Dysfunction
  • Autonomic Dysfunction

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