The main symptoms are tremors, typically described as "pill-rolling
" between the thumb and first two fingers.
Extrapyramidal side effects include early onset dyskinesias, such as dystonias (twisting of the neck or facial spasms); akathisia (inner restlessness with inability to sit still); and Parkinsonian symptoms (bradykinesia, pill-rolling
tremor or shuffling gait); and late onset dyskinesias, such as tardive dyskinesia (irregular jerking movements of the face and extremities) and dystonia.
Tremor in PD is rhythmic with the frequency of 3-5 HZ known as pill-rolling
Course tremor - often described as 'pill-rolling
' of the fingers and thumbs - and additional movements are beyond voluntary control.
Akinesia is a symptom pertaining to bradykinesia (slowness of movement) and muscle stiffness or rigidity. The classic pill-rolling rest tremor associated with IPD is noted when the hand is motionless.
Further, the classic pill-rolling rest tremor is rarely present in MSA.