What are the initial clinical symptoms of Parkinson disease (PD)?

Updated: Aug 29, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Initial clinical symptoms in Parkinson disease include the following:

  • Tremor

  • A subtle decrease in dexterity; for example, a lack of coordination with activities such as playing golf or dressing (about 20% of patients first experience clumsiness in one hand)

  • Decreased arm swing on the first-involved side

  • Soft voice

  • Decreased facial expression

  • Sleep disturbances

  • RBD, in which there is a loss of normal atonia during REM sleep: In one study, 38% of 50-year-old men with RBD and no neurologic signs went on to develop parkinsonism [26] ; patients “act out their dreams” and may kick, hit, talk, or cry out in their sleep

  • Decreased sense of smell

  • Symptoms of autonomic dysfunction, including constipation, sweating abnormalities, sexual dysfunction, and seborrheic dermatitis

  • A general feeling of weakness, malaise, or lassitude

  • Depression or anhedonia

  • Slowness in thinking

Common early motor signs of Parkinson disease include tremor, bradykinesia, rigidity, and dystonia.

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