Parkinson's disease is a progressive neurological disease that affects movement. Although most people would likely think of tremor when considering the symptoms of Parkinson's, the earliest signs can be quite subtle and missed altogether. If you can identify these clues, you might get the treatment as early as possible.

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On World Parkinson's Day, Dr. Anirban Deep Banerjee,  Director, Neurosurgery, Neurosciences, Medanta, Gurugram, provided insights on recognizing the most common early symptoms of this rapidly growing neurological condition worldwide.

Here are 11 early signs you may not know about:

1. Smell Impairment: This is often one of the early signs of Parkinson's disease, which can occur many years before any motor symptoms. One may notice difficulty smelling cinnamon, bananas, or fireplace smoke.

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2. Sleep Difficulties: Many early signs are seen in sleep, restless leg syndrome, dreams acting out, and/or difficulty staying asleep. These conditions can interfere with energy levels and productivity/bother you throughout the day.

3. Constipation: Then some changes are lifestyle choices - changes in bowel habits, especially constipation, can be an earlier sign of Parkinson's disease. These symptoms are probably associated with the subtle influence that Parkinson's disease has on the autonomic nervous system and digestion.

4. Smaller Writing (Micrographia): One may notice that the writing may be smaller and cramped when writing. These are also subtle changes and most likely influenced by subtle motor control affecting writing.

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5. Changes in Voice: One may note a softer or monotonous voice or a hoarse voice. These changes tend to be gradual and, therefore, one may not notice the changes.

6. Masked Face (Hypomimia): A reduction in facial expression that results in you seeming less animated or, in some cases, emotionless can be an early sign, as it results from stiffness in the facial dynamics. 

7. Stooped Posture: A tendency to lean slightly forward or have a stooped posture while standing or walking can be an early warning sign of abnormal tone (stiffness, rigidity) in the body. 

8. Dizziness or Light-headedness: Feeling dizzy or lightheaded, especially upon standing, may be another red flag for Parkinson's disease. This is due to difficulties in blood pressure regulation.

9. Tremor in the Chin, Lip or Leg: Though tremor is a classic symptom of Parkinson's disease, it usually does not develop solely in the hands. Tremor that occurs in the chin, lip or leg and is not as evident, and can be an early sign of Parkinson's.

10. Stiffness or Rigidity: Feeling stiff or rigid in the limbs or body, even in the absence of pain, may be an early sign of Parkinson's disease. This may cause more difficulty in moving and may worsen stooped posture. 

11. Emotional Lability: Sudden and uncontrollable episodes of crying, laughing, or other emotional displays that do not match the circumstance are referred to as emotional lability. While often associated with other neurologic disorders, this can be an early, subtle sign of Parkinson's disease.

Important Note: Experiencing one or more of these symptoms doesn't necessarily mean you have Parkinson's disease. Many of these symptoms can be caused by other conditions. However, if you are concerned about any of these signs, it's important to consult with a doctor for a proper diagnosis and evaluation. Early detection and treatment can help manage the symptoms of Parkinson's and improve your overall well-being.

The article is by Dr. Anirban Deep Banerjee, the Director of Neurosurgery at Medanta, Gurugram, specializing in Functional & Restorative, Skull-Base & Complex Vascular Neurosurgery. He holds extensive qualifications including M.Ch. (Neurosurgery) and M.B.B.S.