PARKINSONS & PARKINSONISM-PRESENTATION

SUMMARY

Signs and symptoms of parkinsonism have 4 major characteristics (4Rs):

1. Resting tremor (4-6Hz). Usually the first symptom noticed.

2. Rigidity. Cog-wheeling due to rigidity & tremor.

3. Retarded movement (bradykinesia and hypokinesia). Decreased amplitude & velocity of repetetive voluntary movements. Causes micrographia (progressive reduction in amplitude of writing), bradykinesia (slow movement), masked facies.

4. Flexed posture & loss of postural Reflexes. Causes festinating gait (the patient walks progressively faster to remain under the forward center of gravity caused by truncal flexion).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].