Parkinson's examination Flashcards
What are the main components to a parkinson’s examination?
- General observations
- Face
- Upper Limb
- Lower Limb
- Extras
What would you look for on general observation of someone with suspected parkinson’s disease?
- Tremor
- Gait
- Posture
What would you look for in the face in somoene with parkinson’s disease?
- Hypomimia
- Decreased blinking
- Drooling
- +ve Glabellar tap
- Hypophonia
- Slow thinking
- Soft faint voice
What would you do as part of a focussed upper limb examination for parkinson’s disease?
- Tone - Lead pipe/cogwheeling
-
Bradykinesia
- Snapper
- Play piano
- Open/close door handle
- Do up buttons
- Micrographia
What would you do aas part of a focussed lower limb assessment for parkinsonism?
-
Bradykinesia
- Heel tap - slow and asynchronous
What would you assess as part of the extras part of a parknisonism examination?
- Function - test undoing buttons, assess writing
-
Exclude parkinson’s plus
- Vertical eye limitation - supranuclear palsy
- Horizontal nystagmus - multisystem atrophy
How would you finish a parkinson’s exam?
- Look for cerebellar signs (MSA)
- Check postural drop (MSA)
- MMSE
- Drugs chart
What are causes of parkinsonism?
- Parkinson’s Disease
- VAscular parkinsonism
- Parkinson’s Plus sydnromes
- Antidepressants
- Wilson’s Disease
What are the parkinson’s plus syndromes?
- Progressive supranuclear palsy
- Multisystem atrophy
- Corticobulbar degeneration
- Dementia with lewy bodies
What are the core features of parkinsonism?
- Tremor
- Bradykinesia
- Postural instability
- Rigidity
How would you test for supranuclear palsy?
- Vertical gaze limitation
- Axial rigidity
How would you assess for multisystem atrophy?
- Cerebellar signs
- Autonomic problems
How would you assess for dementia with lewy bodies?
MMSE
