Examination of a Patient with Parkinson’s Disease

Abstract

Parkinson’s disease (PD) is associated with a combination of characteristic clinical signs which usually allow for prompt and accurate diagnosis. The three cardinal signs of parkinsonism are tremor, rigidity, and bradykinesia. The presence of at least two of these signs is required for the diagnosis of PD. Postural instability is a fourth clinical sign but less useful for early diagnosis as it typically appears later in the course of PD and is a common feature of other forms of parkinsonism. Although the diagnosis of parkinsonism can also be made by dopamine reuptake brain imaging, it is not necessary in the majority of cases as long as a careful and critical neurological examination is carried out by an experienced examiner.

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