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| 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 |
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