How are the nonmotor symptoms of Parkinson disease (PD) categorized?

Updated: Aug 29, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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It is now recognized that in Parkinson disease, nonmotor symptoms may be as troublesome as, or more troublesome than, motor symptoms. Nonmotor symptoms can be categorized as autonomic, cognitive/psychiatric, and sensory [46] and may include depression, dementia, hallucinations, rapid eye movement (REM) sleep behavior disorder (RMD), orthostatic hypotension, and constipation. Nonmotor symptoms can also fluctuate, especially depression, pain, numbness, paresthesia/dysesthesia, akathisia, and restless-legs syndrome. Recognition of nonmotor symptoms of Parkinson disease is essential for appropriate management. [46]

Screen Parkinson disease patients for depression, and treat it when present. An evidence-based guideline from the American Academy of Neurology (AAN) reports that physician recognition of depression is low in Parkinson disease, at less than 30% of clinically proven cases. There are many factors that confound its diagnosis in these patients; and depression has the single largest effect on the quality of life of patients with Parkinson disease. [26, 47]

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