What Are Some Other Symptoms Of Parkinson Disease?

Secondary symptoms may be a combination of one or more primary symptoms, or may occur less frequently, or they may be relatively minor. Some secondary symptoms, however, can result in major disability. Not everyone with PD has the same number or mix of secondary symptoms—they vary from person to person. Understanding these symptoms can reduce their impact on your life. Bladder malfunction, constipation, drooling, and walking difficulties are all secondary symptoms of PD that are discussed later.

Loss of smell (Anosmia) 

Anosmia may be an early symptom of PD. It results from a loss of dopamine cells in a region of the brain called the olfactory cortex. Odors of familiar things such as freshly brewed coffee, baked bread, or perfume may no longer be noticed or appreciated. Loss of smell can also affect one’s sense of taste, leading to decreased appetite and weight loss. PD patients who lose their appetite due to anosmia may find they enjoy highly seasoned or spiced foods.

Muscle pain 

Pain from dystonia: A muscle cramp or “charley horse” is a strong, painful contraction or tightening of a muscle or group of muscles that comes on suddenly and lasts from a few seconds to several hours. It usually occurs in your calf or foot (but may also involve your arms, trunk, back and neck) while you’re resting in bed or exercising. After the cramp disappears the affected muscle or muscles may be sore for several hours. In PD, a common cause of muscle cramps is dystonia: a prolonged twisting or turning of a muscle or group of muscles.

Such cramps usually occur at night, when you’re resting and medication levels are low. If the pain persists despite adjusting your medications, other causes should be sought. If you are having pain from leg cramps, other causes could be a herniated disc in the back.

Pain from rigidity: A dull gnawing pain like the pain of arthritis or a toothache, affecting your shoulder, neck, back, or hip, your main weight bearing regions, may occur early in PD. Such pain is related to rigidity and disappears when a dopamine agonist such as carbidopa/levodopa or Stalevo is started.

It is important to remember that people with PD can have pain for other reasons, the same ones as people without PD. When pain is severe and persistent, it must not be assumed it is related to PD and other causes should be sought.

Fatigue

More than 50% of people with PD complain of fatigue and, in some, fatigue is one of their most disabling symptoms. Fatigue may mean different things to different people. For some, fatigue refers to drowsiness, for others, it may refer to mental or physical depletion. Some patients may feel a combination of all three.

Treatment of fatigue includes eating a balanced diet and getting adequate rest; exercising regularly but without tiring; improving nighttime sleep; pacing yourself physically, emotionally, and intellectually, because too much stress can aggravate symptoms; adjusting anti-Parkinson drug dosages; and treating depression if applicable.

Facial Masking 

Facial masking, or hypomimia, is a loss of facial expression resulting in a “poker” or “masked face” (as though a person is wearing a mask). The masking results in patients not blinking their eyes, not smiling, and often looking sad. Facial masking is due to rigidity and slowness of the facial muscles and is often one of the first symptoms to improve with anti-Parkinson drugs.

Handwriting 

Micrographia is small, cramped handwriting that results from a combination of slowness of movement, incompleteness of movement, and rigidity. Over the years, without your being aware of it, your handwriting may become smaller and more cramped, sometimes becoming completely illegible. Writing a simple sentence once a day, such as “This is a sample of my best handwriting,” is an excellent way to track your PD: as your symptoms improve, your handwriting becomes bigger and less cramped.