Non-motor symptoms are quite common in Parkinson's disease and early onset Parkinson's disease.
There is increasing evidence that non-motor symptoms of Parkinson's disease aren't simply the result of medication side effects or life circumstances, but are caused by the disease itself. Non-motor symptoms affect the way we think, feel and behave. Many young people with Parkinson's focus much of their time and energy on managing the non-motor symptoms of the disease in order to maintain their quality of life and their commitments to family, friends, and career.
IMPORTANT: Not every person will have every non-motor symptom, and not every person will experience the same severity of symptoms.
These are some of the most common non-motor symptoms of PD and may predate motor symptoms by several years. They are particularly challenging symptoms for young people and families because they can decrease or eliminate the motivation to seek or accept help.
People with young onset PD may notice changes in the way they retain and/or process information. Many young people report they are unable to manage as many tasks simultaneously as they once were. Changes in cognition often set off alarm bells; however, memory problems are not necessarily equated with dementia. Cognitive issues related to PD may include:
- Executive functioning (i.e., difficulty multi-tasking)
- Slowed cognitive speed
These symptoms often manifest as obsessive-compulsive behavior such as excessive shopping, gambling, hyper-sexuality, or binge eating. It is important for the person with Parkinson's and the family to be aware of these potential symptoms as they can have devastating consequences. If behavior changes like these should occur, the physician should be notified.
Some experts estimate that as many as 90% of people with PD have experienced some form of sleep disorder. In some cases, these predate motor symptoms by a number of years. Parkinson's medications can cause sleeping difficulties (either too much or too little) as can the disease itself. Inadequate sleep can exacerbate symptoms such as fatigue, anxiety, or cognitive difficulties; the very symptoms younger people need to control in order to continue working and/or taking care of a home and children.
- REM Behavior Disorder
- Restless Leg Syndrome
Autonomic Nervous System Dysfunction
An interruption in the automatic regulation of involuntary body processes can result in a variety of symptoms:
- Constipation and/or urinary frequency: these should be taken seriously and can usually be treated effectively.
- Blood pressure changes: usually dizziness upon standing
- Temperature regulation: feeling very cold or warm, despite normal room temperature; excessive sweating
- Sexual dysfunction
Neurological changes can produce ophthalmologic abnormalities such as:
- Double vision and/or blurry vision
- Decreased blink rate
- Irritation of the eye surface/difficulties opening the eye-lids
It is not uncommon for people with Parkinson's disease to experience sensations such as:
These sensory disturbances can be related to PD. They may also mimic other pathological processes (e.g., a herniated disc causing radiating nerve pain). A thorough workup is required, but if no cause is found, and if PD medicines relieve the sensations, it is likely that the problem is a non-motor feature of PD.
Managing GI Issues in Parkinson's Disease (Webcast). Presented by Ronald F. Pfeiffer, MD. Midwest Parkinson Disease Conference, Des Moines, IA, 2011.
The Brain, Anxiety, and PD (Webcast). Presented by Paul Short, PhD.Southeastern Parkinson Disease Conference. Atlanta, GA, 2010.