Abstract
The clinical diagnosis of Parkinson's disease (PD) is straightforward when the visible motor signs are present. Sensory symptoms, such as pain, anosmia, and depression may precede the development of parkinsonism, sometimes by many years. This chapter focuses on pain and disturbances in smell and vision, and general sensations in PD. The sensory discriminative dimension of pain depends on the intensity, duration, quality, and location of the nociceptive stimulus. Other pain dimensions include the motor, behavioral, affective, and cognitive reactions to the stimulus. The secondary pain syndromes in PD are caused by limb rigidity, dystonia, sleep disorders, gastrointestinal problems, and neck and back pain. Frozen shoulder (accompanied by pain) caused by limb rigidity is one of the presenting symptoms of the disease. Painful dystonia is a less common presenting symptom of PD, but is a frequent problem in more advanced stages.
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