title: Unusual motor and non-motor symptoms and signs in the early stage of Parkinson's disease.
abstract: OBJECTIVE
  Patients with Parkinson's disease (PD) may present with unusual motor and non-motor symptoms and signs in the early stage of the disease.
  
  
  METHODS
  Cases were collected over a five-year period at two tertiary movement disorders clinics. All had a diagnosis of PD with unusual presentations defined retrospectively as the presence of complaints not objectively related to any of the classic cardinal signs of parkinsonism or the typical early non-motor features of PD.
  
  
  RESULTS
  A total of 15 early PD patients fulfilled the proposed criteria, presenting with symptoms such as atypical tremors, shoulder pain, signs related to the rigid akinetic syndrome, as well as cases of asthenia, rhinorrhea, parosmia, dysgeusia, nocturnal sialorrhea, and color discrimination disorders.
  
  
  CONCLUSIONS
  Unusual motor and non-motor symptoms and signs in the early stage of PD can be difficult to interpret. Specialists should be aware of these conditions as clues to a potential diagnosis.
authors.affiliation: Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Curitiba PR, Brasil.
authors.forename: Hélio A G
authors.initials: HA
authors.lastname: Teive
authors.affiliation: Universidade Estadual de Ponta Grossa, Departamento de Medicina Interna, Serviço de Neurologia, Ponta Grossa PR, Brasil.
authors.forename: Délcio C
authors.initials: DC
authors.lastname: Bertucci
authors.affiliation: Toronto University, Toronto Western Hospital, Movement Disorders Centre, Toronto ON, Canada.
authors.forename: Renato P
authors.initials: RP
authors.lastname: Munhoz
mesh_terms: D000368:Aged; D001938:Brazil; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D018476:Hypokinesia / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D000068079:Motor Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology*; D012189:Retrospective Studies; D063189:Symptom Assessment; D014202:Tremor / Q000175:diagnosis / Q000503:physiopathology