Parkinson's disease physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===Appearance=== | ===Appearance=== | ||
In the appearance of [[Parkinson's disease|PD]] patients we can notice that the [[blinking]] rate of spontaneous blinking is lower than normal but voluntary blinking is similar to general population.<ref name="pmid18175339">{{cite journal |vauthors=Agostino R, Bologna M, Dinapoli L, Gregori B, Fabbrini G, Accornero N, Berardelli A |title=Voluntary, spontaneous, and reflex blinking in Parkinson's disease |journal=Mov. Disord. |volume=23 |issue=5 |pages=669–75 |date=April 2008 |pmid=18175339 |doi=10.1002/mds.21887 |url=}}</ref> The other finding in [[Parkinson's disease|PD]] patient is that their spontaneous [[Facial expression|facial expressions]] are less frequent and less varied in comparison to normal people ([[hypomimia]]). | In the appearance of [[Parkinson's disease|PD]] patients we can notice that the [[blinking]] rate of spontaneous blinking is lower than normal but voluntary blinking is similar to general population.<ref name="pmid18175339">{{cite journal |vauthors=Agostino R, Bologna M, Dinapoli L, Gregori B, Fabbrini G, Accornero N, Berardelli A |title=Voluntary, spontaneous, and reflex blinking in Parkinson's disease |journal=Mov. Disord. |volume=23 |issue=5 |pages=669–75 |date=April 2008 |pmid=18175339 |doi=10.1002/mds.21887 |url=}}</ref> The other finding in [[Parkinson's disease|PD]] patient is that their spontaneous [[Facial expression|facial expressions]] are less frequent and less varied in comparison to normal people ([[hypomimia]]).<ref name="pmid24524211">{{cite journal |vauthors=Dumer AI, Oster H, McCabe D, Rabin LA, Spielman JL, Ramig LO, Borod JC |title=Effects of the Lee Silverman Voice Treatment (LSVT® LOUD) on hypomimia in Parkinson's disease |journal=J Int Neuropsychol Soc |volume=20 |issue=3 |pages=302–12 |date=March 2014 |pmid=24524211 |doi=10.1017/S1355617714000046 |url=}}</ref> | ||
===Neurologic=== | ===Neurologic=== | ||
There are currently no blood or laboratory tests that have been proven to help in diagnosing PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. The [[Unified Parkinson's Disease Rating Scale]] is the primary clinical tool used to assist in diagnosis and determine severity of PD. Indeed, only 75% of clinical diagnoses of PD are confirmed at autopsy.<ref>{{cite journal | author = Gelb D, Oliver E, Gilman S | title = Diagnostic criteria for Parkinson disease. | journal = Arch Neurol | volume = 56 | issue = 1 | pages = 33-9 | year = 1999 | pmid = 9923759}}</ref> Early signs and symptoms of PD may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Usually doctors look for shuffling of feet and lack of swing in the arms. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. | There are currently no blood or laboratory tests that have been proven to help in diagnosing PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. The [[Unified Parkinson's Disease Rating Scale]] is the primary clinical tool used to assist in diagnosis and determine severity of PD. Indeed, only 75% of clinical diagnoses of PD are confirmed at autopsy.<ref>{{cite journal | author = Gelb D, Oliver E, Gilman S | title = Diagnostic criteria for Parkinson disease. | journal = Arch Neurol | volume = 56 | issue = 1 | pages = 33-9 | year = 1999 | pmid = 9923759}}</ref> Early signs and symptoms of PD may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Usually doctors look for shuffling of feet and lack of swing in the arms. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. | ||
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Overview
Physical Examination
Appearance
In the appearance of PD patients we can notice that the blinking rate of spontaneous blinking is lower than normal but voluntary blinking is similar to general population.[1] The other finding in PD patient is that their spontaneous facial expressions are less frequent and less varied in comparison to normal people (hypomimia).[2]
Neurologic
There are currently no blood or laboratory tests that have been proven to help in diagnosing PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. The Unified Parkinson's Disease Rating Scale is the primary clinical tool used to assist in diagnosis and determine severity of PD. Indeed, only 75% of clinical diagnoses of PD are confirmed at autopsy.[3] Early signs and symptoms of PD may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Usually doctors look for shuffling of feet and lack of swing in the arms. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.
- Tremor
- Rigidity
- Bradykinesia/Akinesia
- Postural instability
- Shuffling gait
References
- ↑ Agostino R, Bologna M, Dinapoli L, Gregori B, Fabbrini G, Accornero N, Berardelli A (April 2008). "Voluntary, spontaneous, and reflex blinking in Parkinson's disease". Mov. Disord. 23 (5): 669–75. doi:10.1002/mds.21887. PMID 18175339.
- ↑ Dumer AI, Oster H, McCabe D, Rabin LA, Spielman JL, Ramig LO, Borod JC (March 2014). "Effects of the Lee Silverman Voice Treatment (LSVT® LOUD) on hypomimia in Parkinson's disease". J Int Neuropsychol Soc. 20 (3): 302–12. doi:10.1017/S1355617714000046. PMID 24524211.
- ↑ Gelb D, Oliver E, Gilman S (1999). "Diagnostic criteria for Parkinson disease". Arch Neurol. 56 (1): 33–9. PMID 9923759.