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Parkinson's Disease: Causes and Symptoms for Medical Support
Parkinson's Disease: Causes and Symptoms for Medical Support
18 Sep 2023

Parkinson's Disease: Causes and Symptoms for Medical Support

Parkinson's disease is a brain disorder characterised by uncontrollable movements, such as stiffness, shaking, and difficulty with coordination and balance. These symptoms usually start gradually and worsen over time.

As the disease progresses, taking and walking may become difficult. People with the disease may also experience behavioural and mental changes, memory difficulties, fatigue, sleep difficulties and depression.

Anyone can be at risk of Parkinson's disease, but some studies suggest that this disease is more common in men than women. The reason for this is still unclear, but studies are ongoing to understand the factors that may increase the risk of Parkinson's disease.

A clear risk is age. While most people with the disease develop it after age 60, about 5 – 10% of these people experience Parkinson's disease before age 50. The early onset of Parkinson's disease occurs often, but not always. Some forms of the disease have been linked to specific gene alterations.

Types of Parkinson's disease

Parkinsonism is a broad term for several conditions, including Parkinson's and others that cause similar symptoms such as rigidity (stiffness), problems with walking and slow movement.

The three main forms of Parkinsonism are:

  • Vascular Parkinsonism
  • Idiopathic Parkinson's
  • Drug-Induced Parkinsonism

What are the causes of Parkinson's disease?

  • The most common symptoms and signs of Parkinson's disease affect the nerve cells in the basal ganglia, the part of the brain that controls movement, causing the death or impairment of these nerve cells. The basal ganglia nerve cells or neurons produce dopamine, an important brain chemical. When the nerve cells die or get impaired, they produce less amount of dopamine, leading to movement problems common in people with the disease.
  • Parkinson's disease also causes loss of nerve endings responsible for producing norepinephrine, the sympathetic nervous system's main chemical messenger. The sympathetic nervous system controls several body functions, such as blood pressure and heart rate. The loss of norepinephrine may be responsible for non-movement features in people with Parkinson's, such as irregular blood pressure, fatigue, a sudden drop in blood pressure when the person stands from a lying or sitting position, and decreased food movement in the digestive tract.
  • Lewy bodies, the unusual accumulation of protein alpha-synuclein are present in the brain cells of people with Parkinson's. Research is ongoing to understand better the abnormal and normal functions of alpha-synuclein and its link to genetic variants impacting Lewy body dementia and Parkinson's
  • Parkinson's disease may be hereditary, and a few cases have been linked to specific genetic variants. Although genetics can play a role in Parkinson's disease, it doesn't run in families in most cases. Many researchers believe that Parkinson's occurs from environmental factors like exposure to toxins and genetic factors.

What are the symptoms of Parkinson's disease?

The symptoms of Parkinson's often develop gradually and are initially mild. Several symptoms occur with Parkinson's disease, and the order in which they develop, including their severity, differs for every person.

The symptoms include the following, but it is unlikely for a person with Parkinson's disease to experience all or most of them.

Main symptoms

The main Parkinson's symptoms affect physical movement. They include:

  • Tremor – Shaking, which often starts in the arm or hand and likely occurs when the limb is resting or relaxed.
  • Slower movements (bradykinesia) – Physical movements become slower than normal, making performing everyday tasks difficult, resulting in peculiar, slow, shuffling walks with small steps.
  • Muscle stiffness (rigidity) – Muscle tension and stiffness in the muscles make it difficult to make facial expressions and move around. This may cause painful muscle cramps (dystonia)

Doctors may also call these main symptoms Parkinsonism.

Other symptoms

Other symptoms of Parkinson's disease range from mental and physical symptoms

The physical symptoms include:

  • Balance problems that can make people with the condition more likely to injure themselves and have a fall.
  • Loss of sense of smell or anosmia. This may occur several years before other symptoms.
  • Nerve pain which results in unpleasant sensations such as numbness, burning or coldness
  • Problems with peeing, like urinary incontinence (unintentional peeing), having to get up frequently in the night to pee
  • Constipation
  • Being unable to have or sustain an erection (erectile dysfunction) in men
  • Excessive sweating or hyperhidrosis
  • Problems with sleeping (insomnia), which may also cause excessive sleepiness during the day
  • Excessive saliva production (drooling)
  • Difficulty getting sexually aroused or reaching an orgasm (sexual dysfunction) in women
  • Swallowing difficulties (dysphagia), which can cause dehydration and malnutrition
  • Blurred vision, dizziness or fainting when moving from a lying or sitting position to a standing one, resulting from a sudden drop in blood pressure

The psychiatric and cognitive symptoms include:

  • Anxiety and depression
  • Dementia – a group of symptoms, including personality changes, severe memory problems, believing things that aren't true (delusions) and seeing things that aren't there (visual hallucinations)
  • Mild cognitive impairment, which includes slight memory problems and problems with activities requiring organisation and planning

Are you experiencing any of the symptoms outlined in this article?

Contact the clinic today for a same-day GP appointment.

Stages of Parkinson's disease

Parkinson's disease is progressive, meaning the symptoms usually worsen over time. Doctors use the Hoehn and Yahr scale to classify stages of the disease. This scale divides Parkinson's disease into five stages, and it helps healthcare providers learn how the disease signs and symptoms have advanced.

  • Stage 1

This is the mildest form of Parkinson's. In this stage, you may not experience noticeable symptoms, and they may not interfere with your daily tasks and life. If symptoms occur, they only affect one side of the body.

  • Stage 2

It can take months and sometimes years for Parkinson's disease to progress from stage 1 to stage 2. Everyone's experience is unique. At this moderate stage, symptoms may include:

  • Tremors
  • Trembling
  • Muscle stiffness
  • Changes in facial expressions

Muscle stiffness can make daily tasks difficult, prolonging the duration of these tasks. However, at this stage, balance problems aren't common.

Symptoms may occur on both sides of the body, and changes in facial expressions, posture and gait may become more noticeable.

  • Stage 3

At this stage, the symptoms get to a turning point. You are unlikely to experience new symptoms, but the present symptoms become more noticeable and may interfere with your daily tasks.

Movements become noticeably slower, which slows down your activities. Balance issues are also more significant, making falls more common. However, at this stage, people with Parkinson's can still maintain their independence and may not need much assistance.

  • Stage 4

Stage 4 of Parkinson's disease brings significant changes. At this stage, people with Parkinson's disease experience difficulty standing without an assistive device or walker. Muscle movements and reactions are also slower, and living alone isn't advisable as it is unsafe.

  • Stage 5

It is the most advanced stage of Parkinson's disease. It causes severe symptoms that need round-the-clock assistance. Standing becomes difficult and may be impossible. A wheelchair is likely necessary.

People with this stage of Parkinson's disease may experience confusion, hallucinations and delusions. These complications begin in the later stages.

Who can Parkinson's disease affect?

Most people with Parkinson's disease experience symptoms when they are over age 50, but for some, the first symptoms occur when they are below age 40. Men have a slightly higher risk of developing Parkinson's disease than women.

When to seek medical care?

You should see your GP if you have concerns about experiencing symptoms of Parkinson's disease. Your healthcare provider will ask about your medical history and symptoms to determine if referring you to a specialist for further testing is necessary.

Diagnosis of Parkinson's disease

No laboratory or blood tests can diagnose non-genetic cases of Parkinson's disease. Doctors usually diagnose this disease by performing a neurological examination and assessing the person's medical history. If the symptoms improve after taking medications, it may indicate Parkinson's disease.

Several disorders can also cause symptoms similar to Parkinson's disease symptoms. These disorders include dementia with Lewy bodies and multiple system atrophy, collectively known as Parkinsonism.

Doctors may initially misdiagnose these disorders as Parkinson's disease, but some medical tests, including response to drug treatment, can help better evaluate the cause of the symptoms. Several other diseases show similar symptoms but need different treatment, so getting an accurate diagnosis as soon as possible is vital.

Treatment for Parkinson's disease

Parkinson's disease has no cure, but surgical treatments, medicines and other therapies can help relieve some symptoms.

Medicines for Parkinson's disease

Certain medications can help treat Parkinson's symptoms by:

  • Aiding the control of non-movement symptoms
  • Affecting other brain chemicals, such as neurotransmitters, to transfer information between brain cells
  • Increasing the dopamine level in the brain

Levodopa is the main therapy for Parkinson's disease. The nerve cells or neurons use levodopa to make dopamine to replace the reduced dopamine supply in the brain. Most people take levodopa with another medication called carbidopa. This medication reduces levodopa therapy's side effects, including nausea, restlessness, low blood pressure and vomiting, and reduces the amount of levodopa necessary for improving symptoms.

People with Parkinson's must not stop taking levodopa without informing their doctor. A sudden stop in levodopa intake may cause serious effects such as difficulty breathing and inability to move.

The doctor may also prescribe other medicines to manage the symptoms of Parkinson's, such as:

  • Enzyme inhibitors (COMT inhibitors, MAO-B inhibitors) – these help increase dopamine levels in the brain by slowing down the enzymes that break down this chemical compound in the brain
  • Anticholinergic drugs to reduce muddle rigidity and tremors
  • Dopamine agonists to stimulate dopamine production in the brain
  • Amantadine to reduce involuntary movements

Deep brain stimulation

People with Parkinson's disease who don't respond well to medications may need deep brain stimulation. The doctor will implant electrodes into a part of the brain during a surgical procedure and connect the electrodes to a small electrical device implanted in the chest. The electrodes and device painlessly stimulate specific parts of the brain controlling movement to help stop involuntary movements related to Parkinson's disease, such as slow movement, rigidity and tremor.

Other therapies

The following therapies may help manage Parkinson's symptoms.

  • Message therapy to reduce tension
  • Occupational, speech and physical therapies, which may help with voice disorders, decline in mental functions, rigidity, tremors, and gait
  • Exercises that improve balance, coordination and flexibility and strengthen muscles
  • A healthy diet to support overall health
  • Tai chi and yoga to increase flexibility and stretching

Risk factors

The following are risk factors for Parkinson's disease


Parkinson's disease isn't common in young adults. It usually starts in middle to late life, with a higher risk as you age. Most people with Parkinson's disease develop it at about age 60 or older.

A young person with Parkinson's disease may undergo genetic counselling to make family planning decisions. Social situations, medicine side effects and work for a young person differ for an older person with the disease and 2needs special considerations.


Your risk of developing Parkinson's disease is higher if you have a close relative with the disease. However, you still have a small risk, except many people in your family have the disease.


Men have a higher risk for Parkinson's disease than women.

Exposure to toxins

Continuous exposure to pesticides and herbicides may slightly increase the risk of Parkinson's disease.


Parkinson's disease usually comes with other problems. Some of which are treatable. They include:

Thinking difficulties

People with dementia may experience cognitive problems like thinking difficulties and dementia. These often occur in the later stages of Parkinson's.

Emotional changes and depression

People with Parkinson's disease may experience depression in the early stages of the disease. Getting treatment for depression can make handling the challenges of Parkinson's disease and depression easier.

Other emotional changes may affect people with Parkinson's disease, such as anxiety, loss of motivation and fear. Your healthcare professional may administer medicine to treat the symptoms.

Swallowing problems

Difficulty swallowing may occur as the disease progresses. Saliva may accumulate in the mouth from slowed swallowing, causing drooling.

Sleep disorders and sleep problems

People with Parkinson's disease usually have sleep problems, including waking up frequently at night, falling asleep during the day or waking up early.

Some people also experience rapid eye movement and sleep behaviour disorder, including acting out dreams. Taking certain medicines may improve sleep.

Eating and chewing problems

The late stages of Parkinson's disease affect the muscles in the mouth, which makes chewing difficult. This may cause poor nutrition and choking.

Bladder problems

Parkinson's may cause bladder problems, including difficulty urinating or inability to control urine.


Parkinson's disease may cause constipation, mainly from a slower digestive tract.

You may also experience the following.

  • Blood pressure changes – Some people feel lightheaded or dizzy when they stand, resulting from a sudden drop in blood pressure, a condition called orthostatic hypotension
  • Smell dysfunction – problems with the sense of smell may occur, including trouble identifying the difference between odours or certain odours.
  • Fatigue – Parkinson's disease may cause energy loss and fatigue, especially later in the day. The cause of this is still unknown.
  • Pain – Parkinson's may cause pain in specific parts or throughout the body
  • Sexual dysfunction – Some people with Parkinson's disease experience a decrease in sexual performance or desire


The cause of Parkinson's disease is still unclear, so there aren't any proven ways to prevent the disease.

Some research has found that regular aerobic exercise may reduce Parkinson's disease risks, while other research has found that caffeine consumption may reduce the risk of the disease. Green tea can also help reduce the risk of Parkinson's disease. However, the link between caffeine products and reduced risk of Parkinson's is still unclear. There isn't enough evidence suggesting that taking caffeinated beverages helps protect against Parkinson's disease.

If you have Parkinson's disease, follow your healthcare provider's instructions on caring for yourself.

  • Take your prescribed medications.

Taking your prescribed medication can significantly reduce your symptoms. Ensure you take them as prescribed and consult your healthcare provider if you experience side effects or feel the medications aren't working.

  • Visit your provider as recommended.

Your healthcare professional will set a schedule for your visits. These visits are important to manage your conditions and find the right dosages and medications.

  • Do not avoid or ignore symptoms.

Parkinson's disease usually causes different symptoms. Many of these symptoms are treatable by treating the symptoms or conditions. The treatments can significantly improve your health and prevent your symptoms from worsening.

When should I seek care or see my healthcare provider?

Ensure you visit your healthcare professional as recommended or when you notice changes in your symptoms, including your medication's effectiveness. Adjustments to your dosages and medications can make a significant difference in how Parkinson's disease affects you.

If you experience any symptoms of Parkinson's disease or have concerns about developing the disease, visit our Private GP in Harley Street for professional medical care. You can also call us on 020 7499 1991 to schedule an appointment with our doctor.

Concerned about any of the issues raised in this article? It's well worth undergoing a full body health screening to check for underlying issues, with 4 GP appointments included in all Advanced and Elite MOTS throughout 2023.

Frequently asked questions

What can cause Parkinson's disease?

What causes most cases of Parkinson's disease is still unknown. About 10% of Parkinson's disease are genetic, meaning you can inherit the disease from one or both parents. However, 90% of cases are idiopathic, meaning their cause is unknown.

What are the early signs of Parkinson's disease?

The warning signs of Parkinson's disease may be motor (movement-related), such as tremors, stiffness or movements. However, some people also experience non-motor symptoms. Many non-motor symptoms occur years and sometimes decades before the motor symptoms.

However, motor symptoms may be vague, making it difficult to diagnose Parkinson's disease from them.

The non-motor symptoms of Parkinson's disease occurring in the early stages of the disease include:

  • Loss of smell (anosmia)
  • Autonomic nervous symptoms, such as constipation and orthostatic hypotension (lightheadedness when standing up)
  • Sleep problems like rapid eye movement (REM), restless legs syndrome, and periodic limb movement disorder (PLMD)

Is Parkinson's disease fatal?

No, it isn't. Parkinson's disease on its own isn't fatal but may contribute to other problems or conditions that may be fatal.

Is Parkinson's disease curable?

No, it isn't. Parkinson's disease isn't curable but is treatable. Many of its treatments are also effective. Proper care can delay the progress of Parkinson's disease and the more severe symptoms.

People with Parkinson's can live for many years and even decades with the right treatment and management.