21st June 2023

A 67-year-old woman comes into the GP with difficulty walking. She finds it particularly difficult to start moving

A 67-year-old woman comes into the GP with difficulty walking. She finds it particularly difficult to start moving and it gets a bit easier to walk once she’s up and going. She can be dizzy and lightheaded on standing. She had a minor fall against the wall at home a couple of months ago, but she managed to use the wall to prop herself up and prevent a more significant fall with a major injury.

On examination, you notice a resting tremor in both hands and rigidity in both arms.

What is the most likely underlying diagnosis?