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Sensory symptoms in Parkinson's Disease
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DUKE MEDICINE
Mark A Stacy, MD posted:
Sensory complaints in PD are not uncommon, and include visual changes, loss of sense of smell, restless legs syndrome (RLS), and pain. Changes in vision may result from alteration in visual acuity, contrast sensitivity, color discrimination, motion perception, peripheral visual field sensitivity and visual processing speed. Visual acuity can be improved with corrective glasses. Contrast sensitivity and color discrimination is important - especially if you are having trouble with freezing. To help with this problem, try increasing the light in the room, and consider using brighter patterns - sorry I cannot write a prescription to pay for redecorating? Slower visual processing speed also leads to decline in visual perception, particularly for rapidly changing visual activity - birds flying or rapid action on TV. Unfortunately, there is little treatment for these symptoms, but a thorough vision examination will make sure that other eye diseases are not a problem.


Loss of sense of smell has been considered by some to be the earliest symptom of PD, and is seen in up to 90% of PD patients, and this increases as the disease advances. There is no treatment for this symptom.


Restless legs symptoms are commonly reported in PD, usually at the end of a dosing interval - "wearing off." Distinguishing between true RLS and wearing-off limb discomfort and restlessness can be difficult. Nonetheless, the first treatment would be trying to take your PD medication at regular intervals - and dosing prior to the onset of the uncomfortable symptoms. If this is not helpful, medications like clonazepam may be helpful.


Shoulder pain is known to be an early, sometimes initial symptom of PD. Other pain symptoms can be a common complaint in PD, however it is important to differentiate between dystonic (muscle cramping) versus non-dystonic pain. Pain associated with dystonia is likely related to low blood levodopa levels, and responds to levodopa therapy. Non-dystonic pain (numbness, tingling, burning, aching, coldness, heat and pain) in PD is poorly understood and difficult to treat. Sometimes this also responds to treatment with PD medications, and may simply be treated with over the counter drugs like tylenol or ibuprofen. If these do not work, discuss the symptoms with your doctor.
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lovedogs1955 responded:
I am responding to the part about muscle pain in the posting. I started down this PD journey with severe pain in my chest that started with minimum exertion----like talking or laughing. It greatly inhibited my participation in many things. I was given a complete cardiac workup that revealed some minor things, but nothing to cause the severe pain and shortness of breath. Now, I am having the same type of pain in my legs and arms, also occuring with minor exertion. It is of the burning type and lessens when I try and relax or catch a nap. I have been prescribed Ultracet (Ultram Tylenol) for pain for the past 3 years or so and it works for the most part.

I have been declared totally disabled about a year ago. I am a Registerd Nurse, and between the pain, the inablilty to concentrate, and the extreme fatigue, I just can't do the work anymore. Oh yeah, and my voice is VERY soft when the pain in my chest gets bad.
 
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lovedogs1955 responded:
I visited this site again this morning and re-read the original discussion. When the loss of smell was mentioned, I recall that a few months ago I realized I am having that as well. I love going into the Yankee Candle store with a good friend of mine. I could smell the GENERAL overall smells, but was unable to distinguish a smell when trying to smell individual candles.

PD is such a puzzle to patients, their caregivers and medical professionals. We just have to notice everything and keep reporting changes. Of course, some of the changes we patients don't really notice---especially the ones that involve our brain and communication skills.
 
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caregi replied to lovedogs1955's response:
husband,with p.d.always gets pain under his left shoulder blade.it always starts after he begins to eat.he lies down to ease the pain,since no pain med.work,why is this?he was diagnosed less then 3 years with p.d.
 
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Himaja responded:
I guess I have got RLS....please help
 
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DUKE MEDICINE
Mark A Stacy, MD replied to Himaja's response:
Hi, Himaja
RLS symptoms usually disappear with activity, and usually happen in the evening. You may wish to look at rls.org to learn more. I think it is more likely that you have "akathisia," and hope you will talk with your doctor about both of these conditions.
 
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Himaja replied to Mark A Stacy, MD's response:
Thanks a lot doctor, but I guess it was just an assumption, a false one.
I happened to read The Secret by Rhonda Bryne in which she says incurable means "curable from within"
and it does work wonders....I stopped thinking I had a disroder, and I stopped feeling it...thats marvellous..
and thanks for everything,
Love,
Himaja
 
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missytoto responded:
I seem to have a lot of pain in different muscles at different times. Knowing it is parkinsons may help me deal with it - I need more information about everything.
 
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kyrajamine responded:
What are some of the differences between a movement disorder
neurologist and a regular neurologist?
Thank you
 
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blablagirl responded:
have done sensory testing and the diagnosis was very helpfull


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