Parkinson’s is a progressive neurological disease. People with Parkinson’s experience various physical, cognitive, and psychological symptoms. Often, the early symptoms of Parkinson’s are so subtle that the disease goes unnoticed for years. As the disease progresses, a lack of motor skills becomes more apparent. This is followed by cognitive impairments, including trouble following directions and loss of thought.

Doctors look for early evidence of non-motor or pre-motor symptoms long before motor symptoms appear. According to neurologist Dr. Lawrence Severt, the following non-motor symptoms may be early indicators of Parkinson’s:

Parkinson’s disease is primarily a movement disorder. It reduces the amount of dopamine in the brain. Nerve cells use dopamine to send messages that control muscle movement. A brain that’s low in dopamine has less control over muscle function. That lack of control leads to motor symptoms that affect movement.

The four main motor symptoms include:

tremor

muscle rigidity

bradykinesia (slow movement)

poor balance or posture that may affect walking

Not everyone will have all the main motor symptoms. Similar symptoms are also common in other neurological disorders.

Motor symptoms may begin on just one side of the body at first and progress to both sides as the disease worsens. Additional motor symptoms may include the following:

loss of automatic movements, such as smiling and blinking

“masked” face, or a lack of expression

shuffling gait

trouble rising from a seated position

difficulty swallowing or eating

stooped posture

impaired balance

decreased arm swinging when walking

small handwriting

freezing, or walking in quick small steps

trouble moving or turning in bed

slowed daily activities

staying in the same position for long periods

Also, many motor symptoms of Parkinson’s are associated with vision. These symptoms relate to the muscle movements of the eyeball. Vision-related symptoms include: