About Parkinson's

Tremor is one of the three classical symptoms of Parkinson’s. It appears along with stiffness and slowness of movement, but not everyone will develop a tremor. Tremor is an involuntary movement.

Rest tremor is common and occurs when your body is relaxed, you may rub your thumb and forefinger together back and forth – this is called "pill-rolling" rest tremor.

You may also have action tremor, that occurs when trying to do something like hold a magazine.^1-3

Muscle stiffness, or rigidity, may occur in any part of your body and can make movement difficult and painful. It is one of the three classical symptoms of Parkinson’s and appears along with tremor and slowness of movement.^1-3

A key symptom of Parkinson’s is slowness of movement, also called bradykinesia. You might notice it as a shuffling style of walking, or difficulty getting out of a chair. It often makes simple tasks difficult or more time consuming.^1-3

These symptoms are often accompanied by postural instability, where your posture is changed and you have problems with balance, walking or standing.³

During the evening or when you are asleep, you may experience an overwhelming urge to move your legs and you may experience tingling, burning or itching sensation. This is called restless legs and it may keep you awake and cause tiredness during the day or increased sleepiness.

Talk to your doctor or nurse, as it can be treated with lifestyle, dietary changes or medications.^1-3

In Parkinson's, drooling or hypersalivation is very common. Parkinson's affects automatic reflex actions like swallowing, which would normally control the amount of saliva in your mouth.

Referral to a speech and language therapist can help to give you ways to manage swallowing, whilst referral to a physiotherapist may improve your posture which can help.

Also, speak with your doctor who can adjust your Parkinson’s medications or prescribe medicines to help with saliva production.³

Anxiety affects 2 out of 5 people with Parkinson’s¹ and may be worse if you are experiencing problems with medication ‘wearing off’ or motor fluctuations.³ It is not related to the progression of Parkinson’s disease.

There are some forms of anxiety: generalised anxiety disorder, where you experience an excessive and uncontrollable need to worry most of the time; panic attacks, which are periods of sudden, intense feeling of fear leading to a racing heart, sweating and shortness of breath; and phobia, where you feel frightened of something that would not usually make other people feel scared.³

Constipation is the most common complaint in Parkinson’s of the gastrointestinal system and may lead to a feeling of fullness, even after eating small amounts, and a difficulty in passing stools.

If you experience a frequent feeling of fullness or vomiting, speak with your doctor. If you experience constipation or have difficulty in going to the toilet, the increase of fibre in your diet and also in the amount of fluids that you drink may help to improve your symptons.^1,3

In some people with Parkinson’s, as the disease progresses, problems with memory loss or difficulties with thinking may occur.

These symptoms may be a signal for stress, depression or some physical illnesses or may be a sign of dementia.^1,2 If you notice signs of forgetfulness or problems with thinking, speak with your doctor.

In some people with Parkinson’s, as the disease progresses, problems with memory loss or difficulties with thinking may occur. These symptoms may be a signal for stress, depression or some physical illnesses or may be a sign of dementia.

Dementia in people with Parkinson’s requires careful diagnosis to distinguish it from another form of dementia called Dementia with Lewy Bodies (DLB).^1,2

If you notice signs of forgetfulness or problems with thinking, speak with your doctor.

Apathy is a state of indifference, characterised by a lack of emotion, motivation or interest.

People with depression commonly feel sad and low while a person with apathy shows a lack of emotion, whether happy or sad.³

Depression affects around 50% of people with Parkinson’s¹ and can be treated. Self-help treatment includes:

• Regular exercise

• Relaxation

• Accepting help when you need it

Therapeutic treatments and medications are available and can treat depression, so speak with your doctor or nurse.³

Fatigue, a sense of tiredness that does not improve with rest, is common in Parkinson’s and can occur in any patient at any time. At least one-third of people with Parkinson’s are affected.³ The reasons for fatigue are poorly understood and this symptom can be easily overlooked, so it is important to mention this to your doctor or nurse if you are experiencing this.^1-3

People with Parkinson’s may experience problems with sex and intimacy, including reduced sex drive, erectile dysfunction, vaginal dryness, inability to reach orgasm or, in a few cases, an excessive interest in sexual activity or an extremely frequent or suddenly increased libido (hypersexuality).

This may arise from medications used to treat Parkinson’s disease. If you are worried about problems with sex or intimacy, speak to a doctor.⁴

People with Parkinson’s may experience urge incontinence, where you have an urgent need to urinate without warning and nocturia where you may need to get up multiple times in the night to urinate. If affected by urinary problems, speak with your doctor.¹

People with Parkinson’s disease may experience skin problems, including oily skin (known as seborrhoea) particularly on the face and scalp, that means it becomes greasy and shiny. You may also experience a condition called seborrheic dermatitis (skin becomes oily, red, flaky and itchy) which is common in Parkinson’s disease.

If you have oily skin or experience seborrheic dermatitis, talk to a pharmacist or your doctor who will be able to advise on suitable products.³

Excessive sweating may occur in Parkinson’s and can occur as medications start to ‘wear off’ or during the ON time if you have dyskinesia. If sweating becomes troublesome speak with your doctor, nurse, or pharmacist.

Some people with Parkinson’s may not sweat enough, which may be a side effect of some medicines. Sweating is important to regulate your body temperature. If this applies to you, speak with your doctor or specialist nurse as a reduced ability to sweat may cause you to overheat.^2,3

Medications used to treat Parkinson’s disease can cause impulsive behaviour as a side effect. Impulsive behaviours may include unusual, excessive, or increased shopping, sexual behaviour, gambling, medication abuse or binge eating.

Any appearance of impulsive behaviour should be discussed with your doctor as soon as possible.^1-3

Dry mouth may be a side effect of your medicines, so if this affects you, speak with you doctor or specialist nurse as they may be able to change your medicines or change the doses.

You can also suck on hard candy/sweets to help your mouth produce more saliva. Speak with your pharmacist or dentist, who may be able to advise you on options that may help.⁵

Problems with swallowing, known as dysphagia, may develop slowly over time and include drooling, food sticking in your throat, choking, and coughing. If this affects you, you may not eat as much as you should to avoid the issue.

Talk to your doctor or specialist nurse as soon as you notice a problem, as they can refer you to other specialists, such as speech and language therapists.^1-3

Many people with Parkinson’s may experience mild memory or thinking problems (for example slowness of thought). These symptoms do not mean you have dementia and may be caused by other reasons, such as lack of sleep or anxiety and depression.

It is important to speak with your doctor or specialist nurse if you experience symptoms of memory impairment or problems with thinking.^1-3

You may experience sleep problems, such as insomnia, where you can’t get to sleep or stay asleep. As insomnia can be caused by some medications, speak with your doctor or specialist nurse if this is troublesome.

You may also experience nocturia where you need to get up multiple times in the night to urinate. Another condition associated with Parkinson’s is rapid eye movement disorder, which may cause you to have vivid dreams or talking and moving when you are asleep. If you experience these symptoms speak with your doctor or specialist nurse.^1-3

Most people with Parkinson’s will notice a reduced ability to smell (hyposmia), or a complete loss (anosmia). This can change the way you can taste food or detect odours.

Although there is currently no known treatment to improve the sense of smell, you should let tell your doctor or nurse if you notice this symptom.^1-3