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Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal thinking; balance problems; change in the amount of urine produced; chest pain; confusion; dark urine; decreased sexual ability; difficulty walking; fainting; hallucinations; memory problems; muscle pain, tenderness, or weakness; new or unusual skin growths or change in the appearance of a mole; new or worsening mental, mood, or behavior changes (eg, aggression, agitation, paranoia); severe or persistent dizziness, drowsiness, or sleepiness; shortness of breath; sudden irresistible urge to sleep or suddenly falling asleep at unusual times; sudden, unexplained weight gain; swelling of the hands, ankles, legs, or feet; trouble swallowing; unusual or intense urges (eg, gambling, sexual urges); unusual twitching or muscle movements; vision changes.

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The fourth cardinal sign, postural instability (balance difficulty), emerges late in the disease, usually after 8 years or more.

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Polymeropoulos MH, Lavedan C, Leroy E, et al: Mutation in the alpha-synuclein gene identified in families with Parkinson's disease.

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Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE; Parkinson Study Group DATATOP Investigators: Predictors of deterioration in health-related quality of life in Parkinson's disease: results from the DATATOP trial.

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However, there is no indication that RLS is related to, or is a precursor of, Parkinson's disease.

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