Smooth and coordinated muscle movements of the body are made possible by a substance in the brain called dopamine. Dopamine is produced in a part of the brain called the “substantia nigra.” In Parkinson’s, the cells of the substantia nigra start to die. When this happens, dopamine levels are reduced. When they have dropped 60 to 80 percent, symptoms of Parkinson’s start to appear.
• Tremors or shaking of hands, arms, legs, jaw, or head
• Stiffness of arms, legs, and trunk
• Slowed movement
• Trouble with balance and coordination
Parkinson’s is a progressive disease. That means that your symptoms usually get worse over time. The symptoms of Parkinson’s also vary a lot from one person to the next. How quickly it worsens and how severe it gets can vary a lot, too. Early symptoms may be easy to ignore or dismiss. They might start on one side of your body, showing up on the other side only later.
Thinking difficulties – You may experience cognitive problems (dementia) and thinking difficulties. These usually occur in the later stages of Parkinson’s disease. Such cognitive problems aren’t very responsive to medications.
Depression and emotional changes – You may experience depression, sometimes in the very early stages. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson’s disease.
You may also experience other emotional changes, such as fear, anxiety or loss of motivation. Doctors may give you medications to treat these symptoms.
Swallowing problems – You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
Chewing and eating problems – Late-stage Parkinson’s disease affects the muscles in your mouth, making chewing difficult. This can lead to choking and poor nutrition.
Sleep problems and sleep disorders – People with Parkinson’s disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day. People may also experience rapid eye movement sleep behavior disorder, which involves acting out your dreams. Medications may help your sleep problems.
Bladder problems – Parkinson’s disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
Constipation – Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.
Blood pressure changes You may feel dizzy or lightheaded when you stand due to a sudden drop in blood pressure (orthostatic hypotension).
Smell dysfunction You may experience problems with your sense of smell. You may have difficulty identifying certain odors or the difference between odors.
Fatigue Many people with Parkinson’s disease lose energy and experience fatigue, especially later in the day. The cause isn’t always known.
Pain – Some people with Parkinson’s disease experience pain, either in specific areas of their bodies or throughout their bodies.
Sexual dysfunction – Some people with Parkinson’s disease notice a decrease in sexual desire or performance.