Many symptoms that don't involve movement can be a warning sign for Parkinson's. They may start years or even decades before motor symptoms.
Some non-motor signs include a mask-like facial expression, drooling and cramped handwriting. Others are less obvious, such as a change in your sense of smell or trouble swallowing.
1. Tremor
The most common tremor is a rhythmic shaking that usually starts in one part of your body, such as your hands or fingers. Depending on what causes it, it may stop when you use the affected area or decrease when you are at rest. It might get worse when you are excited or stressed and it can even affect your voice.
You should always see your doctor to evaluate any tremors, especially if they are ongoing. They can help you distinguish tremors from other conditions and offer treatments. If your tremors are mild, you may not need treatment, but if they interfere with your daily activities or are embarrassing to others, medication can help. For example, the benzodiazepines alprazolam (Xanax), clonazepam (Klonopin) and diazepam (Valium) can ease tremors.
2. Stiffness
Stiffness is a common symptom in people with PD. It can affect any part of your body and it often gets worse over time. It can be triggered by exercise, medications or even certain foods. It can also make your muscles tighten and stiffen, leading to painful spasms.
Everyone feels a little stiff and slow when they first get out of bed in the morning, but this symptom could be an early warning sign for Parkinsons if it doesn't go away as you move around during the day. You can reduce this symptom by doing muscle stretches, walking and other low-intensity physical activity.
This symptom may be an early warning sign for Parkinsons because it can be caused by antibodies to a chemical called glutamic acid decarboxylase (GAD). These are made in the brain and attack healthy cells that help produce gamma-aminobutryic acid, which controls muscle movement.
3. Fatigue
Fatigue can be a tricky symptom to notice as it often sneaks up on you. However, if family and friends notice you aren’t as active as they used to, make sure they bring this to your attention.
The best way to diagnose fatigue is by keeping a diary of your daily activities and when you feel most or least energetic. This will help your doctor identify any patterns in your symptoms that could be causing your fatigue.
There are many treatable contributors to fatigue like anemia, sleep apnea, OFF states and motor de-conditioning that can be improved with medication or changes in diet or lifestyle. Depression is also linked with fatigue so be sure to discuss this with your doctor too. They may prescribe antidepressants to ease the symptom and improve your sleeping patterns.
4. Difficulty with Balance and Coordination
The sense of balance is a combination of signals from the eyes, ears, muscles and touch sensors in your legs. When Parkinson’s disease starts to affect these areas, it may cause balance problems. This can also lead to a stooped posture and a feeling of unsteadiness or faintness when standing up from sitting or lying down.
A slowed pace of movement is another early warning sign of Parkinson’s, called bradykinesia. This can include taking longer to dress, preparing meals and doing other daily tasks. It may also affect the speed of blinking or facial expressions.
Difficulty with balance and coordination is not as common as the other motor (movement-related) symptoms but is still important to consider. It is often a precursor to the development of other non-motor symptoms such as loss of smell (anosmia) and sleep disorders including periodic limb movement disorder and REM behavior disorder.
5. Difficulty with Speech
During childhood, you may have stuttered or lisped as you learned to speak. While it was endearing as a child, it can be frustrating as an adult. People with PD often find that their speech becomes slurred or difficult to pronounce.
Swallowing problems (dysphagia) can also occur at any stage of PD and often get worse over time. Swallowing issues can cause drooling, coughing or choking when eating or drinking, weight loss and dehydration.
Difficulty with speech can be an important warning sign. If you begin to have difficulty communicating, it is a good idea to carry emergency contact numbers and consider signing up for a service that provides buttons you can press when you are alone to alert others and/or your local emergency services to your situation.
