Parkinson disease
From IDWiki
Definition
- Degenerative neurological disorder characterized by progressive bradykinesia, rest tremor, rigidity, and postural instability
Pathophysiology
- Destruction of substantia nigra
Differential Diagnosis
Clinical Presentation
- Rest tremor at 4-6 Hz, inhibited by movement and sleep, worsened by stress
- Pill-rolling
- Rigidity, with increased tone and cog-wheeling
- No spasticity
- Often worse with repeated flexion
- Bradykinesia
- Short, shuffling gait with festination
- Loss of arm swing
- Micrographia
- Postural hypotension
- Glabellar tap reflex, normally stops after 5-10 taps
JAMA Rational Clinical Exam
- Change in speech (LR+ 2.6, LR- 0.73)
- ...