Non-Motor Symptoms of Parkinson's

Parkinson’s disease (PD) is characterized by the primary motor symptoms of tremor, rigidity, postural instability (impaired balance), and bradykinesia (slowing down and loss of spontaneous movement). PD also affects the autonomic nervous system, the part of the nervous system that controls organs throughout the body. The neurons (nerve cells) can become dysfunctional, causing non-motor symptoms including:

  • Reduced sense of smell, also known as hyposmia
  • Gastrointestinal issues, such as constipation or slowed movement of food from the stomach into the intestines (gastroparesis)
  • Urinary issues, like a frequent and urgent need to urinate
  • Orthostatic hypotension, a drop in blood pressure that occurs upon standing
  • Excessive salivation
  • Excessive sweating
  • Disturbances in sleep and wakefulness, such as excessive daytime sleepiness, fatigue, REM sleep behavior (acting out dreams while asleep), or restless leg syndrome (an irresistible urge to move the legs)
  • Mood changes, like depression or anxiety
  • Cognitive changes, like memory difficulties, slowed thinking, confusion, difficulty with planning, visual-spatial difficulties (like getting lost in a familiar place), or dementia
  • Psychotic symptoms, like hallucinations, delusions, or paranoia
  • Sexual dysfunction, like erectile dysfunction in men or poor lubrication in women
  • Pain, which may be musculoskeletal pain, nerve pain, pain due to dystonia (prolonged twisting or muscle contractions), discomfort due to restlessness, or a pain syndrome (primary or central pain)
  • Weight loss or weight gain
  • Vision problems, like blurry vision, dry eyes, or difficulty opening eyes
  • Dental problems
  • Skin problems, like dry skin, oily skin, dandruff, or excessive sweating
  • Impulsive behaviors, like excessive shopping, unusual or increased sexual behavior, gambling, abuse of medications, or binge eating (impulsive behaviors may be caused as a side effect of medication and should be discussed with a physician)1,2

Parkinson’s disease is unique

Not everyone with PD experiences the same symptoms, making PD a highly variable disease. Symptoms may differ in severity among different patients, and each case of PD progresses on an individual level.1

Treating non-motor symptoms of Parkinson’s disease

There is currently no known cure for PD, although there are treatments available that can help manage the symptoms. Treatments of the non-motor symptoms are specific to the symptoms experienced. Some of the non-motor symptoms, such as constipation, some sleep problems, psychotic symptoms, or impulsive behaviors, may be caused as a side effect of medications used to treat the motor symptoms of PD. Other non-motor symptoms have both pharmacological and other therapy strategies that can help. For example, there are medications that can work to reduce an overactive bladder in people who experience urinary problems, and pain may be relieved through a combination of medication, physical therapy, and exercise. However, some medications may make the symptoms of PD worse and should be discussed with a movement disorders specialist who is trained to understand complex medication interactions. Complementary therapies, such as acupuncture or massage, may also help relieve non-motor symptoms of PD.1

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Written by: Emily Downward | Last reviewed: March 2017