There are 4 important signs
1) Shaking at rest (tremor)
2)Rigidity
3)slow in initiate the movement (bradykinesia)
4)Postural instability (occur late in the disease)
1)Tremor at rest
-tremor may appear like rolling or oscillating the hand or arms
-earlier only arm affected but after a few months or years, both arms may be affected
-the tremor is start and stop (on and off)
-it is worsen when under stress
-it is relieve during rest or sleep
-tremor usually involve tongue, lips or chin
2)Rigidity
-rigidity means increase the resistance when someone else want to move your joint such as during flexion or extension of affected limb
-The resistance can be either smooth (lead-pipe) or start and stop (cog wheeling).
3)Bradykinesia
-meaning slow during movement, unplanned movement and decrease size of movement
-also expressed as micrographia (small handwriting), hypomimia (decreased facial expression), decreased blink rate, and hypophonia (soft speech).
4)Postural instability
-this is due to imbalance and loss of reflexes which it is very important to keep in upright positio
Other symptoms
-experience freezing when starting to walk (start-hesitation), during turning, or crossing a threshold such as going through a doorway.
-Flexed postures of neck, trunk, and limbs may occur.
-Altered mental status generally occurs late in PD and affects 15-30% of people with PD.
-Short-term memory and visio-spacial function may be impaired.
-The onset of PD is typically lopsided, with the most common initial finding being an asymmetric rest tremor in one arm. About 20% of people first experience clumsiness in 1 hand.
-Over time, you will notice symptoms related to progressive bradykinesia, rigidity, and problems with walking (called gait disturbances).
The initial symptoms of PD may be nonspecific and include fatigue and depression.
- Some people experience a subtle decrease in dexterity and may notice a lack of coordination with activities such as golf, dressing, or climbing stairs.
- Some people complain of aching or tightness in the calf or shoulder region.
- The first affected arm may not swing fully when walking, and the foot on the same side may scrape the floor.
- Over time, posture becomes progressively flexed and your stride becomes shorter leading to a shuffling gait.
- Decreased swallowing may lead to excess saliva and ultimately drooling.
- Symptoms of problems with your involuntary nervous system are common and may include constipation, sweating abnormalities, and sexual dysfunction.
- Sleep disturbances are also common.