Symptoms of parkinsonism may include:

• Decrease in facial expressions
• Difficulty starting and controlling movement
• Soft voice
• Some types of paralysis
• Stiffness of the trunk, arms, or legs
• Tremor

Although cognitive problems are not as common in Parkinson's disease, they may be more likely in secondary parkinsonism. This is because the diseases that cause secondary parkinsonism often lead to dementia.

For a more detailed description of symptoms, see Parkinson's disease.

The health care provider may be able to diagnose secondary parkinsonism based on your history, symptoms, and a physical examination. However, the symptoms may be difficult to assess, particularly in the elderly.

Examination may show:

• Difficulty starting or stopping voluntary movements
• Increased muscle tone
• Problems with posture
• Slow, shuffling walk (gait)
• Tremors of the Parkinson's type

Reflexes are usually normal.

Tests are not usually specific for secondary parkinsonism. However, they may be used to confirm or rule out other disorders that can cause similar symptoms.