What are the non-motor symptoms?
Constipation - In Parkinson disease this can relate to a dysfunction of the autonomic nerve supply to the bowel as well as slowed transit through the bowel. This is best managed with laxatives- discussed below.
Drooling - Some patients with Parkinson disease will experience drooling from the mouth.
Lightheadedness on Standing up (orthostatic hypotension) - This commonly occurs in association with Parkinson disease. It is where blood pressure drops on standing up which can cause the symptom of lightheadedness or fainting episodes. It can be exacerbated also by some of the medications used to treat Parkinson disease. It can be a disabling symptom however there are many ways of managing it ranging from lifestyle measures to medications (see below and autonomic disorders page).
Sexual Dysfunction - This can occur in Parkinson disease and can be underactivity or overactivity. Erectile dysfunction in men is common in Parkinson disease especially if the autonomic nervous system is involved (see autonomic disorders page). Sexual overactivity tends to occur in younger men and those treated with the class of medication called dopamine agonists (described below).
Sleep disorders - Some patients with Parkinson disease have trouble sleeping. This can range from trouble falling asleep, waking up during the night or falling asleep during the day. They can also develop a condition called rapid eye movement (REM) sleep behaviour disorder. In REM sleep dreaming occurs in conjunction with loss of muscle tone. In REM sleep behaviour disorder the dreaming occurs without the loss of muscle tone- what happens is the dreams may be acted out which obviously can put the patient in danger.
Depression - Sometimes patients with Parkinson disease experience depression and emotional problems. Treatment of depression can make it easier to deal with the challenges posed by having a chronic illness such as Parkinson disease.
Cognitive impairment - This commonly occurs in Parkinson disease but in general it occurs to a much greater extent in older patients. The cognitive processes that are involved in Parkinson disease are those that are involved in “executive” function. This simply means tasks such as planning, attention and shifting attention from one thing to another. There can also be issues with visuospatial function and this simply refers to interpretation and perception of things and people that you can see. An example would be facial recognition. Memory tends to be less frequently involved in the cognitive issues seen in Parkinson disease. Visual hallucinations also commonly occur. Of the types of dementia (described on the dementia page) the dementia associated with Parkinson disease is most similar (and possibly indistinct from) dementia with Lewy bodies. If the signs of Parkinson disease are present for one year or more before the onset of cognitive issues it is called Parkinson Disease Dementia (PDD) and if the cognitive issues start before the typical features of Parkinson disease or at the same time then it is called Lewy Body Dementia (LBD) but ultimately the symptoms will be quite similar and the treatment is the same.