Clinical Features

Clinical Presentation of PDThe characteristic symptoms of PD are tremor, bradykinesia, rigidity and postural instabilityParkinson's disease presents with a range of motor, cognitive, psychiatric, sensory, and autonomic symptoms.

Some of the physical challenges PD patients face are symptoms inherent to the disease, while others are treatment-related side effects. Some of the most onerous phenomena seen in PD patients, such as dyskinesia, are side effects of drug therapies that aim at reducing the effects of the dopamine depletion that occurs as a result of PD pathology.

The initial diagnosis of PD is based on medical history and a neurological examination using clinical scales to test for the presence of characteristic motor symptoms: tremor, bradykinesia, rigidity, and postural instability. Non-motor symptoms of PD (cognitive, psychiatric, autonomic, sensory and sleep disorders) present with considerable variability, and there is evidence that some (such as anosmia) can predate the occurrence of motor symptoms.

Symptoms of PD can also be categorized by whether or not they are responsive to dopamine replacement therapies. So-called ‘dopamine non-responsive symptoms’ include gait disorders and various non-motor symptoms.