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Medicine

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Neurology

Question
3 out of 18
 

Which is a clinical feature of parkinsonism?



A Micrographia
B Decrease blink rate

C Myerson’s sign
D All of the above

Ans. D

All of the above

A. Parkinson’s Disease

Definition – It is a chronic, progressive disorder in which idiopathic parkinsonism (i.e. variable combination of tremor, rigidity brady kinesia, gait disturbance)

Pathogenesis It is due to loss of nerve cells in the pigmented substantia nigra pars compacta, symptoms occur when there is loss of at least 80% cell loss. There is an imbalance between dopamine and acetyl choline neurotransmitters (either an increase in acetylcholine or a decrease in dopamine level)

Clinical Features – (Ref. Hari-18th ed., pg- 3317)

1). General –

Expressionless face with straight look with infrequent blinking.

Rapid, monotonous speech.

Flexed posture (universal flexion)

2). Gait –

Festinating gait

3). Tremor -
Resting tremors – 4 – 8 /Sec

Usually first in fingers/ thumb

Pill rolling movements

4). Rigidity –

Cogwheel type – mostly appreciated in upper limbs especially in wrist joint

Plastic (lead pipe) – mostly appreciated in the legs and trunk.

In the trunk rigidity manifests itself by the presence of a flexed and stooped posture.

5). Hypokinesis - Handwriting – micrographia

6). Eye Signs in Parkinsonism –


a. Decrease Blink rate

b. Impaired smooth pursuit

c. Hypometric saccades

d. Myerson’s sign (Glabellar tap sign)

e. Blepharospasm

f. Reversed Argyll Robertson pupils (post encephalitic

g. parkinsonism)


Extra Edge:

1). Glabellar reflex (also known as the "glabellar tap sign")

a. It is a primitive reflex.

b. It is elicited by repetitive tapping on the forehead.

c. Subjects blink in response to the first several taps.

d. If the blinking persists

2). Myerson's sign and is abnormal

3). The afferent trigeminal nerve, and the efferent the facial nerve

Myerson's sign is often seen in patients with Parkinson's disease.

Neurology Flashcard List

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