Symptoms

The symptoms of Parkinson's disease usually develop gradually and aremild at first.

There are many different symptoms associated with Parkinson's disease. Some of the more common symptoms are described below.

However,the order in which these develop and their severity is different for each individual.It's unlikely thata personwith Parkinson's disease would experience all ormost of these.

Main symptoms

The three main symptoms of Parkinson's disease affect physical movement:

• tremor shaking, which usually begins in the hand or arm and is more likely to occur when the limb is relaxed andresting
• slowness of movement (bradykinesia) where physical movements are much slower than normal, which can make everyday tasks difficult and can result in a distinctive slow, shuffling walk with very small steps
• muscle stiffness (rigidity) stiffness and tension in the muscles, which can make it difficult to move around and make facial expressions, and can result in painful muscle cramps (dystonia)

These mainsymptoms are sometimes referred to by doctors as parkinsonism as there can be causes other than Parkinson's disease.

Other symptoms

Parkinson's disease can also cause a range of other physical and mental symptoms.

Physical symptoms

• balance problems these can make someone with the condition more likely to have a fall and injure themselves
• loss of sense of smell (anosmia) sometimes occurs several years before other symptoms develop
• nerve pain can cause unpleasant sensations, such as burning, coldness or numbness
• problems with urination such as having to get up frequently during the night to urinate orunintentionally passing urine (urinary incontinence)
• constipation
• an inability to obtain or sustain an erection (erectile dysfunction) in men
• difficulty becoming sexually aroused and achieving an orgasm(sexual dysfunction) in women
• dizziness , blurred vision or fainting when moving from a sitting or lying position to a standing onecaused by a sudden drop in blood pressure
• excessive sweating (hyperhidrosis)
• swallowing difficulties (dysphagia) this can lead to malnutrition and dehydration
• excessive production of saliva (drooling)
• problems sleeping (insomnia) this can result in excessive sleepiness during the day

Cognitive and psychiatric symptoms

• depression and anxiety
• mild cognitive impairment slight memory problems and problems with activities that require planning and organisation
• dementia a group of symptoms, including more severe memory problems, personality changes,seeing things that aren't there (visual hallucinations ) andbelieving things that aren't true (delusions)

When to seek medical advice

See your GP if you're concerned you may have symptoms of Parkinson's disease.

Your GP will ask about your symptoms and your medical history to help them decide whether it's necessary to refer you to a specialist for further tests.

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