Parkinson's Exam
 

Parkinsonism

 
 
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Overview

    • Clinical Features

    • Resting tremor
    • Rigidity - leadpipe, cogwheel
    • Akinesia - hypokinesia (small movements), bradykinesia (slow movements)
    • Postural instability - reduced postural reflexes
    • Causes of Parkinsonism

    • Parkinson’s disease - Parkinsonism, anosmia, REM sleep behavioural disturbance, frontal executive dysfunction, depression
    • Parkinson’s Plus Syndromes

    • Progressive supranuclear palsy (PSP) - Parkinsonism with supranuclear downward gaze palsy (inability to look down)
    • Multiple systems atrophy (MSA) - Parkinsonism, autonomic dysfunction, cerebellar involvement and pyramidal signs
    • Dementia with Lewy Bodies (DLB) - Parkinsonism, visual hallucinations, fluctuating cognition
    • Corticobasal degeneration (CBD) - rigidity, dystonia, focal myoclonus, ideomotor apraxia, alien limb syndrome
    • Others

    • Drugs - antipsychotics, metoclopramide, lithium
    • Normal pressure hydrocephalus
    • Hypoxic brain injury
    • Wilson’s disease
 
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