Parkinsonism
Parkinsonism vs Parkinson's Disease
PARKINSONISM
Sequelae of findings found in typical and atypical Parkinson's Disease.
PARKINSON'S DISEASE
Asymmetric disorder of stiffness and slowness of movement with frequent falls and difficulty with sudden changes in movement that typically responds to dopamine replacement.
PARKINSONISM
Hypokinetic manifestations
- Failure of Glabellar tap to disappear (normally disappears after 4 — 5 taps)
- Soft, rapid voice
- Drooling
- Bilateral mimetic (aka emotional) facial palsy
- “Masked Facies” with little emotional play
- Ignition failure with gait.
- Motor rigidity
- Cog-wheeling: alternating agonist/antagonist contractions
- Catch in the alternation (Negri’s sign) of movement, most easily palpated at the wrist.
- Micrographia
- Bradykinesia
- Slow movement, delayed initiation, minimal spontaneous movement
- Rare blinking (“serpentine stare”)
- Inability to turn over in bed/Difficulty in changing motor programs
- Freezing when passing through a doorway
- Uses small cautious steps and changes directions
- Stooped posture (forward, flexed)
- Pill rolling (4-7 Hz) tremor) at rest, extinguishes with action
- Vertical head tremor
- Dyskinesia (typically with treatment)
- Dystonia
Video Reference
- Selections of video from Jung E. Park, Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea