Parkinson’s Early Signs and Symptoms

Parkinson’s Disease Impacts Estimated 1 Million Americans

By Karen Hales, Neurology Solutions Contributing Writer

Parkinson’s disease (PD) is a neurological disorder that leads to motor symptoms such as shaking and difficulty with movement and coordination. The brain disorder affects an estimated 1 million Americans and 7 to 10 million people worldwide. Approximately 60,000 Americans are diagnosed with PD each year, according to the National Institutes of Health. This article will provide information on Parkinson’s early signs and symptoms and help answer the question “what is Parkinson’s?”

What is Parkinson’s disease?

Parkinson's early signs symptoms
Men are twice as likely to be diagnosed with Parkinson’s as women.

PD is a progressive degenerative disorder of the nervous system that impacts, among other things, movement. It comes on gradually, initially noticed as shaking (tremor) in one hand or on one side of the body. As time progresses, the symptoms worsen and become more pronounced and noticeable. While tremor is the most well-known sign of PD, the condition can also cause stiffness, slowing of movement, foot dragging, and freezing (individual has trouble continuing forward movement). Activities such as shaving, getting in and out of bed, turning over, using cutlery, dressing oneself, walking and even swallowing can eventually become more difficult and time-consuming.

Parkinson’s disease is a brain disorder that impacts nerve cells in a part of the brain called the substantia nigra that produce dopamine, a neurotransmitter. In PD, these nerve cells, called alpha-synuclein proteins, break down, impairing the production of dopamine. Dopamine acts as a transmitter for signals from the brain to other parts of the body. It is essential for movement and also plays a large role in learning and regulating mood.

Who is affected by PD?

The average age of a Parkinson’s diagnosis is 56. Approximately 4 percent of Parkinson’s patients are diagnosed before the age of 50. Young Onset Parkinson’s disease (YOPD) is considered a diagnosis before the age of 40. The disease is twice as likely to affect men than women.

How is Parkinson’s diagnosed?

No one test or scan can diagnose Parkinson’s disease. Doctors look for four classic symptoms before reaching a PD diagnosis: tremors, rigidity in the wrist and elbow joints, lack or slowness of movement, and unstable posture.

Disease state and progression of PD is measured through a motor exam using the Unified Parkinson’s Disease Rating Scale (UPDRS), a tool that evaluates factors such as reflexes, tremor, coordination, balance, posture, rigidity, gait, eye movement, mental functioning, mood and social interaction. Brain scans also may be used to assess activity and function of brain regions involved in movement and can help rule out other conditions such as stroke or brain tumor. Scientists continue to gain greater understanding of PD through continued research to develop better treatments and a potential cure for the disease.

Parkinson’s Early Signs & Symptoms

Due to the complexity of the disease, a diagnosis of PD is based on a variety of factors. Parkinson’s early signs include a wide range of cognitive, mood and motor symptoms.

  • Difficulty walking, the inability to walk naturally or swing ones arms is an early symptom of PD. People with PD also may take short, uneven steps (shuffling), suffer from freezing spells, as well as experience difficulty judging obstacles and negotiating turns and corners.
  • Tremors, particularly in the arms or hands. In early stages of the disease, tremor is usually experienced in one limb or on one side of the body, but other parts of the body may be affected as the disease progresses.
  • Bradykinesia is the gradual degradation of movement caused by the brain’s lethargy in transmitting instructions to the desired parts of the body. Bradykinesia can affect facial muscles that may give the sufferer a mask-like appearance.
  • Trouble with balance can be an early warning symptom of PD.
  • Depression is common for people with PD.
  • Loss of fine motor skills.
  • Loss of sense of smell.
  • Changes in handwriting, either shaky handwriting or writing smaller than usual.
  • Changes in voice and speech patterns, such as softening voice or difficulty enunciating.
  • Trouble sleeping or REM Sleep Behavior Disorder (RBD), which causes people to act out dreams.
  • Memory loss, trouble problem-solving or decline in mental abilities.
  • Skin disorders such as dry rough skin or dandruff.

What causes Parkinson’s symptoms?

While Parkinson’s disease’s impact on the brain is better understood today, the cause of the condition is unknown. Research points to a combination of environmental and genetic factors. Scientists are looking for links between Parkinson’s disease and genetics, aging, toxins in the environment, and free radicals, which react with certain chemicals in the body and may interfere with the ability of cells to function normally.

The process of impairment of brain cells is called neurodegeneration. When approximately 60 to 80 percent of the dopamine-producing cells are damaged, the motor symptoms of Parkinson’s disease appear. This results in an aggravation of motor and non motor symptoms.

What are lesser-known PD symptoms?

Parkinson’s disease is a multi-system disease with wide-ranging impacts. In addition to the condition’s more commonly recognized motor symptoms, people with Parkinson’s may experience apathy, fatigue, depression, anxiety, mood issues, low blood pressure, constipation, pain, trouble sleeping and difficulty swallowing and projecting their voice.

Treatment for Early Stage Parkinson’s

Several recent research developments have brought new hope for treating symptoms of Parkinson’s disease and developing therapies to potentially slow disease process.

Medications such as dopamine replacement therapy and dopamine-inhibitors, which mimic the effect of dopamine on the brain, are among the main medication treatments for primary symptoms of PD.

Movement specialists trained in managing Parkinson’s disease

Individuals diagnosed with PD and other parkinsonism syndromes should seek the advice of doctors who specialize in treating these complex movement disorders, even when the illness is only suspected. Choices about medications made early in the course of Parkinson’s disease can have a lasting impact on the course of the illness.

Movement disorder specialists have extensive experience treating these conditions and managing medication side effects and disease progression to maintain patients’ quality of life.  Individuals with PD should seek a medication review at least annually to ensure they are taking advantage of the latest most effective treatments for managing symptoms.


Neurology Solutions is accepting new patients seeking a specialist in managing Parkinson’s disease, dystonia, essential tremor and age-related movement disorders. If you are seeking another opinion on diagnosing your condition or managing symptoms of a movement disorder, please contact Neurology Solutions or call 512-865-6310 to schedule an appointment.

Stay informed by frequenting Neurology Solutions’ blog, or join Neurology Solutions Movement Disorders Center’s email list to stay up to date on the latest in treatments and how to manage stress, stay healthy and maintain quality of life while living with dystonia, PD and other movement disorders.

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