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Parkinsonism - GENERAL


A syndrome characterized by tremor, muscular rigidity, akinesia, and loss of postural reflexes.

Classification and Etiology:

The constellation of symptoms described below occurs in both primary parkinsonism (Parkinson's disease) and secondary parkinsonism (Parkinson's syndrome).

Primary parkinsonism:

When no cause can be distinguished, the condition is designated as primary parkinsonism. Most cases of parkinsonism belong in this category. The disease most frequently appears between the ages of 50 and 79 yr, but the incidence declines beyond the eighth decade.

Secondary parkinsonism:

Secondary parkinsonism is distinguished from primary parkinsonism by having a known cause.


Atherosclerosis of cerebral vessels
Drugs and toxins
Metabolic disorders
Head trauma
Degenerative disorders

Symptoms and Signs:

The most common initial symptom is tremor, usually in one hand or sometimes in both and involving the fingers in a pill-rolling motion. The tremor is present at rest (resting tremor).

Muscular rigidity is usually readily evident on passive movement of a limb.

Gait becomes shuffled with short steps, and the arms fail to swing. Postural abnormalities are evident in the erect and sitting positions.

The face can become masklike, with lack of expression and diminished eye blinking.

Mood abnormalities, usually depression or anxiety, are common and may be the heralding symptoms.


  • Medications

  • Physical Medicine Rehabilitation

  • Surgery/Surgical Treatment :  A new approach to replenishing the dopamine deficit by transplantation or grafting of fetal nigral cells to the corpus striatum shows promise.