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Parkinson’s symptoms: 10 initial and early symptoms

Parkinson’s is a neurodegenerative disease that leads to the death of brain cells that synthesize and release dopamine. By the time the first substantial symptoms of Parkinson’s appear, 40 to 50 percent of dopamine-producing neurons have already been lost. Therefore, it is paramount to identify the disease as early as possible.

Some subtle Parkinson’s symptoms can appear early in the disease but often go unnoticed. Even doctors miss these symptoms, tending not to give them proper consideration.

Furthermore, an April 2011 survey by  the National Parkinson’s Foundation found that many people avoid visiting a doctor, even in the presence of troubling Parkinson’s symptoms such as a tremor.

Here is a list of the top ten most often overlooked symptoms that could help you identify and receive early treatment for Parkinson’s.

10 early signs of parkinson's, how to recognize it

One of the least known symptoms of Parkinson’s: loss of the sense of smell


This is one of the strangest, least-known symptoms of Parkinson’s. It is often the first warning sign of the disease, but it is almost always spotted too late.

As a result, loss of taste may also occur, as it is highly integrated with the sense of smell.

Dopamine is a neurotransmitter whose job is to transport signals between the brain, muscles and nerves throughout the body. When the cells (neurons) that produce dopamine start to die, as is the case in Parkinson’s, the sense of smell is compromised.



Sleep problems as symptoms of Parkinson’s


Another symptom experienced by people with Parkinson’s is rapid eye movement sleep behavior disorder (RBD). Here, people tend to move during the rapid eye movement (REM) sleep phase, the deepest part of the sleep cycle. People with this disorder may shout, kick or grind their teeth, but they can also attack their bedmates.

About 40 percent of people with RBD develop Parkinson’s, even up to ten years after the onset of symptoms.

Two other sleep-related symptoms that are commonly associated with Parkinson’s disease are restless leg syndrome (a tingling sensation in the legs and the feeling that you have to move them) and sleep apnea (suddenly and temporarily stopping breathing during sleep).

These symptoms do not in themselves indicate the presence of Parkinson’s, of course, but many Parkinson’s patients – up to 40 percent in the case of sleep apnea – exhibit these symptoms.

Bowel and bladder symptoms


Another common symptom of Parkinson’s – one that is very often neglected, since it can have many causes – is constipation and intestinal gas.

This is because Parkinson’s also affects the autonomic nervous system, which regulates the activity of the smooth muscles of which the bowels and bladder are made. Therefore, the muscles of the bowels and bladder become less sensitive and efficient, thus slowing down the digestive process.

The difference between ordinary constipation and constipation caused by Parkinson’s disease is that, in the second case, there is also a prolonged feeling of fullness, even if the sufferer has had little to eat.

In the case of the urinary tract, some people with Parkinson’s have difficulty urinating, while others suffer from incontinence.


Parkinson’s symptoms and lack of facial expression


A shortage of dopamine can also affect the facial muscles, which become stiff and slow, causing problems in expressiveness. The face no longer expresses the person’s emotions and feelings.

As the disease progresses, this symptom worsens until reaching its extreme form, indicated by the term “Parkinson’s mask”, which occurs in the advanced disease stages.

The changes are minor: initially you notice a certain slowness in smiling or frowning, in looking into the distance, or abnormal blinking.

early symptoms of Parkinson's sore neck
A common symptom of Parkinson’s among women: neck soreness

Neck soreness related to Parkinson’s disease appears mostly in women. This was highlighted in a study reporting it as the third most frequent Parkinson’s symptom (after tremor and stiffness).

Neck pain caused by Parkinson’s persists for a long time, unlike common neck pain that should go away after a few days.

This symptom can sometimes manifest itself more as a numbness or a tingling sensation. It could also present itself as a discomfort that leads to frequent attempts to stretch the neck.


Other symptoms of Parkinson’s: bradykinesia and difficulty in writing


One of the main symptoms of Parkinson’s, known as bradykinesia, is the slowing of spontaneous and routine movements.

The slowing down of writing is one of the first signs of bradykinesia and is one of the most characteristic symptoms of Parkinson’s involving the loss of spontaneous movements.

Sufferers start to find it difficult to write and writing often becomes smaller and more cramped than before.

Other disorders that reveal the onset of bradykinesia are difficulty in getting washed and dressed. Doing up buttons or zippers can often take a long time.


Changes in the tone of voice and speech


The voice of a person with Parkinson’s often changes, becoming weaker and more monotone.
This Parkinson’s symptom is the one that should worry a patient’s family and friends most, as it starts long before the other common disorders become apparent.

Having difficulty pronouncing certain words can also be indicative of Parkinson’s. This is due to stiffened facial muscles, which make speaking clearly more difficult.

With Parkinson’s, the arms do not swing freely


Another characteristic symptom of Parkinson’s is reduced arm movement while walking.

While walking, our arms usually swing alongside our hips. In Parkinson’s patients this does not happen, due to the muscle stiffness caused by the disease.

“With the onset of Parkinson’s disease, people begin to have what we call increased tone, which means the muscles are stiffer and more limited,”, confirms Dr Santamaria, a neurologist and Parkinson’s expert at the Nebraska Medical Center in Omaha. The arm just won’t go where the brain tells it to go.

Unlike arthritis or injuries, joint damage is not involved and there is no pain.


Excessive sweating can be a symptom of Parkinson’s


As already mentioned, Parkinson’s affects the autonomic nervous system, damaging the body’s ability to thermally self-regulate, thus causing changes in the skin and sweat glands.

These changes cause uncontrollable sweating with no plausible reason, such as heat or anxiety.

This possible symptom of Parkinson’s is called hyperhidrosis and is very similar to hot flashes that often occur during menopause.

Many sufferers also have an excessive salivation problem, but this is caused by a difficulty in swallowing, rather than by a higher production of saliva.

Parkinson’s symptoms and mood and personality changes

Although the causes are still unclear, certain personality changes have been noted in Parkinson’s patients, such as increased anxiety in new situations, social withdrawal and depression.

Several studies show that depression is often the first symptom of Parkinson’s to be noticed, but it is not initially linked to the condition.

Changes in cognitive skills also appear in some people, particularly when it comes to concentration and cognitive functions that control movement.

The first sign of cognitive decline is the loss of the ability to multitask.

Some experts believe that thinking problems also affect the mood because the sense of mental difficulty can induce anxiety, a feeling of being overwhelmed and social withdrawal.

Parkinson's disease could create mood swings