The most common symptoms of Parkinson’s disease
Slowness of movements (bradykinesia):
The patient’s movements become slower and the range of motion decreases (hypokinesia), which may worsen to total loss of motion (akinesia). Both voluntary and autonomic muscle control may be affected. All movements are unnaturally slow. The posture is stooped, steps are small, and/or patients scuttle or shuffle when they walk. Starting or stopping a movement is also difficult. Sudden stopping of a movement, so-called “freezing“, occurs frequently. This increases the risk of falling. Facial expressions and gestures are reduced; laughing and crying seem delayed and look like a grimace. The face seems to become an unmoving mask. The abilities to speak and swallow may also be affected. Fine motor function worsens: manipulating buttons or opening/closing zippers becomes difficult; writing becomes illegible; brushing teeth becomes impossible.
Reactions and accompanying movements are also affected. The patient doesn’t move his or her arms when walking or simply “falls” into a seat due to poor balance. Parkinson’s disease also reduces the speed of thought processes.
Stiff muscles:
Parkinson’s disease increases muscle tone, causing the body to become stiffer. Both contracting and stretching muscles may be affected. Deliberate relaxation is not possible. Passively moving parts of the body results in the so-called “cogwheel” phenomenon. The muscles relax in bursts, like a cogwheel. Typical for this stiffness of the muscles is the “floating pillow” sign. When the patient lies down on their back, they cannot put their head down. The muscles are so tense that the head seems to “float” above the pillow.
Shaking (tremor):
When relaxed, arms or legs may shake. One half of the body is often more severely affected than the other. Shaking usually occurs in the hands and arms.
Insufficient stability of posture (postural control):
Righting and postural reflexes are continuously and unconsciously correcting the position and posture of our body. This balancing process prevents falls. In patients with Parkinson’s disease, the righting and postural reflexes are interrupted. Patients struggle to remain upright. Sudden, unforeseen changes in movement can no longer be countered and corrected in time. Their gait becomes insecure, and they tend to fall more often.
Other symptoms:
Patients may also have difficulties swallowing or suffer from incontinence, insomnia, depression, and dementia. Hallucinations, delusions, and paranoia often accompany dementia.