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Symptoms

PD is primarily a disorder of movement and its defining symptoms are physical in nature. The core features of Parkinsonian disorders stem from disruption of the neural pathways responsible for the control and initation of movement and are listed below. Typically, they are appear unilaterally (affecting one side of the body) at first, with symptoms spreading eventually to the other side of the body. Some rare cases may be bilateral at disease onset.

Resting tremor
This manifests when the limb in at rest. The classical PD tremor is the so-called "pill-rolling" motion, as if a small object is being continually rolled between the thumb and fingers. There may also be a postural tremor.
Bradykinesia
Slowness of movement.
Hypokinesia
Reduced amplitude, or size, of movement.
Akinesia
Absence of normal unconscious movements The most common example of this is the loss of the notmal arm swing motion when walking.
Postural instability
This often occurs later in the disease course, resulting in a tendency to stumble and fall.
Rigidity
Stiffness of the limbs, demonstrated by resistance to passive movement.
Freezing
Inability to initiate a voluntary movement.

Effects of the above problems include difficulty with fine movements (demonstrated by a decrease in handwriting size, or micrographia), reduced blinking and loss of facial expression, loss of balance and a stooped posture.

In addition to motor dysfunction, some patients may experience a number of secondary symptoms. These include mental disturbances (commonly dementia [30%] and depression [40%]), sensory disruption (pain — especially in tremor — impaired sense of smell or taste disturbances) or autonomic dysfunction.

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