Progression of Parkinson's disease symptoms

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Progression of Parkinson's disease symptoms

Early disease

Tremor is usually the first symptom of Parkinson's disease, appearing in just one limb (arm or leg) or on only one side of the body. Tremor may also occur in the lips, tongue, jaw, and eyelids. As the disease progresses, the tremor usually spreads to both sides of the body, although in some cases the tremor remains on just one side. Joint pain, weakness, and fatigue may develop.

Slow movement, stiff muscles, and poor coordination may occur early on in the disease. Problems with fine motor skills can affect tasks such as writing, shaving, or brushing teeth. Changes in handwriting are common. A person in the early stages of Parkinson's disease may move slowly and may not make normal, frequent posture adjustments.

Advanced disease

As the disease progresses, problems with posture and balance develop. A person with Parkinson's disease tends to walk in a stooped manner with quick, shuffling steps.

After several years, as muscle stiffness and tremor increase, the person may become unable to care for himself or herself. Weak, stiff muscles eventually may confine the person to a wheelchair or bed.

In addition to worsening disease symptoms, people who have taken levodopa for several years may develop additional movement problems. These motor fluctuations can be reduced somewhat by making changes in the person's medication, but they can be difficult to control and may further complicate treatment.

Dementia may develop in up to one-third of people who have late-stage Parkinson's disease. Dementia symptoms may include disorientation at night, confusion, and memory loss. Medications that are used to treat Parkinson's disease can also contribute to this problem.

Credits

Last updated:	December 13, 2006
Author:	Monica Rhodes
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, Colin Chalk, MD, CM, FRCPC - Neurology
Editors:	Kathleen M. Ariss, MS, Pat Truman