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. 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.