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.1
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.