What will happen when actor Michael J. Fox meet the former heavyweight boxing champion Muhammad Ali? Answer: Both men with Parkinson's disease are discussing about raising funds for research and increasing awareness about this degenerative nerve condition.
Parkinson's disease is common in our daily practice as a physician. In fact, it is the main focus of a short case in 3% of attempts at PACES station 3, CNS.
The common PACES scenario would be:
- Talk to the patient and proceed - monotonous speech
- This patient has unsteady gait. Please examine.- festinant, shuffling gait
By one look, you will notice the patient has expressionless, unblinking face. Then, look for hand tremor. Take a pillow and REST the elbow on the pillow to demonstrate resting tremor. Proceed by checking the presence of rigidity and bradykinesia. Once you demonstrated the 3 signs of Parkisonism, don't stop at this stage. As a physician, you need to assess the possibility of Parkinson's plus syndromes.
- Olivopontocerebellar degeneneration: check for cerebellar signs
- Steele-Richardson-Olszewski disease: check for gaze palsy and pyramidal signs
- Progressive autonomic failure(Shy-Drager syndrome): check for postural hypotension
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