|
Symptom or sign | Description |
|
Cardinal motor symptoms and signs | |
Bradykinesia | Slowness of voluntary movement and/or a movement that is ongoing. For the companion terms akinesia and hypokinesia, see below |
Rest tremor | Asymmetric 4–6 Hz moderate amplitude tremor, which usually involves the thumb (pill-rolling tremor). It may involve other body parts, such as the forearm pronation/supination, the leg adduction/abduction, and the jaw. Head tremor is rarely seen in PD. For other PD tremor types, see the text |
Rigidity | Increased muscle tone felt during examination by passive movement of the affected segment, involving both flexor and extensor muscles and not increased with higher mobilization speed (in contrast with spasticity) |
Postural instability | Impaired postural adjustment due to decrease or loss of postural reflexes |
Other motor symptoms and signs (early and advanced disease stages) | |
Akinesia | Reduction, delay, or absence of either voluntary, spontaneous, or associated movement |
Hypokinesia | Reduced movement amplitude, particularly with repetitive movements |
Hypomimia | Reduced facial expression |
Hypophonia | Reduced voice volume |
Micrographia | Small handwriting that becomes progressively smaller and less readable |
Festination | Involuntary gait acceleration with step shortening |
Tachyphemia | Acceleration of speech segments |
Sialorrhea | Drooling of saliva |
Dysarthria | Slurred speech |
Dysphagia | Difficulty in swallowing |
On phase | A phase characterized by a beneficial effect of levodopa with release from the parkinsonian symptoms and signs |
Off phase | A phase, in which the parkinsonian symptoms and signs take over, sometimes in the form of a crisis with severe bradykinesia, rigidity, and tremor. Nonmotor off features include pain, paresthesia, sweating, thoracic oppression, and anxiety symptoms |
Freezing of gait | Difficulty in gait initiation (start hesitation) and paroxysmal unintentional episodes of motor block during walking |
Postural instability | Impaired postural adjustment due to decrease or loss of postural reflexes |
Akathisia | Feeling of inner restlessness and strong need to be in constant motion associated with the inability to sit or stay still |
Camptocormia | Abnormal involuntary flexion of the trunk that appears when standing or walking and disappears in the supine position |
Anterocollis | Marked neck flexion (>45%), disproportionate to trunk flexion |
Pisa syndrome | Tonic lateral flexion of the trunk associated with slight rotation along the sagittal plane |
Selected nonmotor symptoms and signs | |
Hyposmia/anosmia | Reduction/loss of the sense of smell |
Constipation | Infrequent and frequently incomplete bowel movements |
Orthostatic hypotension | A decrease in systolic blood pressure of at least 20 mm Hg or a decrease in diastolic blood pressure of at least 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position |
Fatigue | Overwhelming sense of tiredness and feeling of exhaustion with difficulties in initiating and sustaining mental and physical tasks |
Apathy | Lack of motivation characterized by diminished goal-oriented behavior and cognition and reduced emotional expression |
Restless legs syndrome | Movement disorder characterized by compelling urge to move the legs, particularly when in bed and trying to sleep |
|