Parkinson’s Disease

Parkinson's disease symptoms and the onset of symptoms vary among patients and change over time. Some symptoms may not occur until a later stage or might never occur. Patients and families may notice some or all of these symptoms:

• Bradykinesia: Slowness in voluntary movement caused by loss of dopamine, which delays the transmission of signals from the brain to the skeletal muscles. Bradykinesia causes difficulty in initiating and completing movements and an expressionless, mask-like face.
• Tremors: Shaking in the hands, forearms, or feet when a limb is at rest but not when performing tasks. Tremors can also occur in the mouth and chin.
• Rigidity: Stiff muscles that can produce muscle pain. Stiffness tends to increase during movement.
• Poor balance: Shuffling steps and unsteadiness caused by losing the reflexes that manage posture.
• Speech problems: Hypophonia appears as reduced voice volume and loss of tone or emotion. Patients may develop slurring, stuttering, or stammering, with slower or faster speech.
• Difficulty swallowing: Dysphagia occurs as the throat muscles lose function. This can cause choking, coughing, or excessive throat-clearing. It might feel like food gets "stuck" on the way down.

Parkinson's disease can also causes non-motor symptoms, such as:

• Mood changes: Anxiety, depression, or apathy.
• Constipation: Lost ability of muscle control in the digestive tract can cause difficulty with bowel movements.
• Loss of smell: Reduced sense of smell can affect your ability to enjoy food.
• Sleep disturbances: Patients may have trouble sleeping or act out their dreams during deep sleep.

Some medications cause side effects that mimic Parkinson’s disease symptoms. Talk with a doctor about any concerning signs of disease. A specialist can diagnose Parkinson’s or determine another cause of your symptoms.

There is no blood test to screen for Parkinson’s disease, and symptoms may mirror other disorders. The first step of diagnosis is to get a comprehensive neurological exam from a specialist. Your care team will also evaluate your complete medical history.

Research and technology innovations are streamlining diagnosis:

• A new type of skin biopsy can detect the presence of the problematic alpha-synuclein protein.
• A dopamine transporter scan (DaTscan) is a special nuclear medicine imaging test. A technician injects a radioactive tracer called Ioflupane into a vein. It attaches to dopamine transporting enzymes, allowing your doctor to see if there is a loss of dopamine in the brain.

Your neurologist might also use a CT scan or MRI to rule out disorders that cause similar symptoms.