Specialties: Dementia, cerebrovascular diseases (stroke), neurological pain, facial nerve paralysis, dizziness/headaches, Parkinson's disease, brain disorders, epilepsy

What is Parkinson’s Disease?

     In 1817, British physician James Parkinson first described a group of patients with clinical symptoms such as resting tremor, slowness of movement, limb stiffness, and shuffling gait in his essay “An Essay on the Shaking Palsy.” This condition was later named Parkinson’s Disease (PD).

    Parkinson’s Disease is the second most common neurodegenerative disorder, typically affecting middle-aged and elderly individuals (>50–60 years old). Early on, it impairs motor function, and gradually, other nervous systems (such as the autonomic nervous system and cognitive function) are also involved. The incidence in men is slightly higher than in women.

Typical Symptoms of Parkinson’s Disease

Due to degeneration of the basal ganglia and substantia nigra, the brain cannot produce enough dopamine (<80%), leading to motor impairment. Common signs include: masked facial expression, muscle rigidity, tremors of the limbs, reduced motor ability, difficulty initiating movement, and slowness of actions.

Non-Motor Symptoms of Parkinson’s Disease

     When we hear “Parkinson’s Disease,” most people think of tremors, stiffness, and slow movements — the motor symptoms. However, Parkinson’s also includes many non-motor symptoms, which often appear earlier and can impact quality of life even more severely. Recognizing these symptoms helps patients and families seek medical care earlier and improve daily living.

1. Sleep Disorders

• Difficulty falling asleep, light sleep, frequent awakenings at night
• Talking, moving, or even “acting out dreams” during sleep — known as REM sleep behavior disorder
• Excessive daytime sleepiness, poor concentration

? Sleep problems not only cause fatigue but also increase the risk of falls and accidents during the day.

2. Autonomic Dysfunction

• Constipation: due to slow gastrointestinal motility, one of the most common problems
• Urinary problems: frequency, urgency, nocturia
• Sweating abnormalities: excessive or reduced sweating
• Orthostatic hypotension: dizziness or blacking out when standing up

? These symptoms are often overlooked but can greatly affect daily life. Discuss management strategies with your doctor.

3. Emotional and Psychiatric Symptoms

• Depression and anxiety: often more distressing than motor disability
• Cognitive decline: poor memory, difficulty concentrating
• Hallucinations or delusions: sometimes caused by long-term medication
• Impulse control disorders: few patient taking dopamine agonists may develop compulsive gambling, shopping, overeating, or hypersexuality

? Early recognition and medical consultation can help improve these issues with medication adjustments or supportive therapies.

4. Sensory Abnormalities

• Loss of smell: often occurs years before motor symptoms
• Pain, numbness, burning sensations; sometimes accompanied by Restless Legs Syndrome
• Reduced sense of taste

? These changes are not life-threatening but significantly affect eating, sleep, and quality of life.

5. Fatigue and General Discomfort

• Unexplained chronic fatigue
• Reduced energy, lack of motivation

? These conditions are often mistaken for “aging” or “lack of rest,” but they are closely related to Parkinson’s Disease itself.

Why Do These Symptoms Occur?

     Parkinson’s disease does not only affect the brain regions that control movement (basal ganglia and substantia nigra). It also involves neurotransmitter systems that regulate autonomic function, emotions, sleep, and sensory processing. Therefore, PD leads to systemic changes, not just tremor or stiffness.

Coping and Management Strategies

1. Communicate with Your Doctor

• Report severe constipation, insomnia, or emotional distress, as many of these symptoms can be treated (with medication, diet, or rehabilitation).
• Seek professional support when needed (neurologist, psychiatrist, rehabilitation physician, psychologist, nutritionist).

2. Lifestyle Adjustments

• Regular exercise: walking, tai chi, stretching — can improve sleep and gut function
• Balanced diet: high-fiber foods and adequate hydration to ease constipation
• Sleep hygiene: fixed sleep schedule, avoid caffeine, limit excessive naps

3. Family Support

• Understand emotional changes and provide patience
• Help monitor medication side effects and daily difficulties

Key Takeaways

• Non-motor symptoms may appear before motor symptoms
• They often impact quality of life more severely than tremors or slowness
• Early recognition, proactive treatment, and supportive care can significantly improve living quality

?  Conclusion
Parkinson’s Disease is not just a condition of “slowness and tremor.” It is a chronic illness that affects the whole person. Understanding non-motor symptoms, seeking timely diagnosis, and working with the healthcare team are essential steps for patients and families. If you or a loved one experience these symptoms — especially in combination with tremors or slowed movements — consult a neurologist. Early diagnosis and treatment can greatly enhance quality of life.