Regarding Clinical Features In Parkinson's Disease

You review a 70-year-old who has developed a tremor in his right hand. Which of the following best describes the typical symptoms seen in Parkinson's disease?
A. Resting tremor + bradykinesia + fasciculation
B. Intention tremor + chorea + lead-pipe rigidity
C. Resting tremor + bradykinesia + rigidity
D. Resting tremor + chorea + cogwheel rigidity
E. Intention tremor + bradykinesia + rigidity

Answer:
C. Resting tremor + bradykinesia + rigidity

Discussion:
Parkinson's disease: is a progressive neurodegenerative condition caused by degeneration of dopaminergic neurons in the substantia nigra.. This results in a classic triad of features:

• bradykinesia, 
• tremor and 
• rigidity. 

The symptoms of Parkinson's disease are characteristically asymmetrical.

Epidemiology;
 around twice as common in men
 mean age of diagnosis is 65 years

Clinical Features: 
1. Bradykinesia 
 poverty of movement also seen, sometimes referred to as hypokinesia
 short, shuffling steps with reduced arm swinging
 difficulty in initiating movement

2. Tremor 
 most marked at rest, 3-5 Hz
 worse when stressed or tired
 typically 'pill-rolling', i.e. in the thumb and index finger

3.Rigidity 
 lead pipe
 cogwheel: due to superimposed tremor

Other characteristic features 
 mask-like facies
 flexed posture
 micrographia
 drooling of saliva
 psychiatric features: depression is the most common feature (affects about 40%); dementia, psychosis and sleep disturbances may also occur
 impaired olfaction