11th August 2024

Parkinsonism

Parkinsonism is the triad of:

• Akinesia and bradykinesia
• Tremor: a resting tremor; described as ‘pill rolling’ when limited to the fingers
• Rigidity: lead-pipe (constant resistance to motion) and cogwheel (intermittent resistance to passive movement)

Although not part of the triad, the festinant, stooped, slow-turning gait of parkinsonism is also a cardinal sign.

Parkinsonism is due to impaired functioning of the basal ganglia. It most commonly presents due to idiopathic Parkinson’s disease (PD), but can be caused by a number of other conditions, including vascular disease (vascular parkinsonism), Parkinson’s plus syndromes, Wilson’s disease, post encephalitis, drug induced (antipsychotics most commonly) or toxins (carbon monoxide, MPTP [1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine]).