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Parkinson’s Disease

Discussion
Discussion

A 68-year-old man presented to the neurology clinic with a gradual onset of tremors in his right hand over the past year. His wife also noted that he had become slower in performing daily activities, such as buttoning his shirt and writing. Over the past six months, he developed a shuffling gait, occasional imbalance, and a noticeable reduction in facial expression. He did not report any significant memory problems or changes in mood. On physical examination, the patient had a resting tremor in his right hand, which improved with voluntary movement. Bradykinesia was evident, with slowed movements in both upper and lower extremities. Muscle rigidity was present in the right arm, and there was a mild stooped posture. His gait was characterized by short, shuffling steps, and he had difficulty turning around quickly. The patient’s medical history was notable for hypertension, but he had no history of strokes, head trauma, or exposure to toxins. There was no known family history of Parkinson’s disease. A diagnosis of idiopathic Parkinson’s disease was made based on the clinical presentation and neurological exam findings. The neurologist discussed treatment options, including initiating levodopa therapy to help manage symptoms. The patient and his family were also advised on lifestyle modifications, such as physical therapy and regular exercise, to maintain mobility and independence. A follow-up visit was scheduled to monitor his response to treatment and adjust the medication as needed.

Questions
1. What was the first symptom that led the patient to seek medical attention?

a) Memory problems
b) Tremor in the right hand
c) Difficulty speaking
d) Severe headaches

2. What was one of the key findings during the patient’s physical examination?

a) Loss of vision
b) Muscle rigidity in the right arm

c) Severe muscle weakness
d) Numbness in both legs

3. Which treatment was discussed as a primary option for managing the patient’s symptoms?

a) Corticosteroids
b) Surgery
c) Levodopa therapy
d) Physical therapy alone

4. What lifestyle modification was recommended to help the patient maintain mobility and independence?

a) Complete bed rest
b) Regular exercise and physical therapy
c) Dietary changes only
d) Use of a wheelchair

Reveal answers

Answers

1. b) Tremor in the right hand
2. b) Muscle rigidity in the right arm
3. c) Levodopa therapy
4. b) Regular exercise and physical therapy