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Initial symptoms may be mild and nonspecific (such as mild tremor, slight feeling that one leg/foot is stiff or dragging).
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Muscle rigidity:
- Stiffness
- Difficulty bending arms or legs
- Posture may be unstable, stooped, or slumped over
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Movement difficulties:
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Loss of balance
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Gait (walking pattern) changes
- Shuffling
- Slow movements
- Difficulty beginning to walk, difficulty initiating any voluntary movement
- Small steps followed by the need to run to maintain balance
- Freezing of movement when the movement is stopped, unable to resume movement
- Muscle aches and pains (myalgia)
- Muscle cramps and dystonia
- Shaking, tremors (varying degrees, may not be present):
- May occur at rest or at any time
- May become severe enough to interfere with activities
- May be worse when tired, excited, or stressed
- Finger-thumb rubbing (pill rolling tremor) may be present
- Changes in facial expression:
- Reduced ability to show facial expressions, "mask" appearance
- Staring
- Eye movement abnormality (difficulty moving eyes up and down)
- May be unable to close mouth
- Voice or speech changes:
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Difficulty chewing or swallowing
- Loss of fine motor skills:
- Difficulty writing, may be small and illegible
- Difficulty eating
- Difficulty with any activity that requires small movements
- Frequent falls
- Mild decline in intellectual function (may occur)
Symptoms that may also be seen or develop:
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