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Frequency is slow 4 7hzq only in some patients

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. Frequency is slow, (4- 7hzQ only) . In some patients typical “pill rolling ” appearance may occur. Rigidity:- • Leadpipe(Smooth resistance to passive movement) . Cogwheel rigidity may also occur More obvious in extremities and may later become prominent in the axial musculatures. 532
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Bradykinesia:- Movement is slow and delayed, initially distally and later in the proximal muscles. There are many manifestations of bradykinesia including:- Reduced facial expressions, - Drooling of saliva - Reduced blinking, - Reduced arm swing while walking, - Difficulty turning in bed, or rising from a chair, - Slowness of gait and small shuffling steps 533
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Repetitive movements show slowing and reduced amplitude, finger movements are particularly affected and become clumsy and laboured. Handwriting becomes small and spidery at an early stage (micrographia) and may be a presenting symptom 534
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Postural instability:- It is not often an early symptom. . Postural reflexes are not preserved, patient has a tendency to topple forwards or backwards if pushed or pulled. When walking there is a liability to topple forward with faster steps and difficulty stopping (festination). Falls increase and gait develops into the typical slow shuffling walk with small steps on a narrow base (festinating gait). • There is delay in the initiation of the gait and the patient becomes intermittently stuck and unable to move . Eventually it is impossible to walk unaided. 535
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In Parkinsonism, what is not present - (May 94) a) Tremors at rest b) Past pointing c) Akinesia d) Rigidity B. “Past pointing is a feature of cerebellar disease”. 536
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Wheel chair sign of Quinn is used as a typical red flag sign in - (NBE/DNB Pattern) a) Idiopathic parkinsonism b) Duchenne muscular dystrophy c) Becker’s dystrophy d) Thomson disease 537
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Wheelchair Sign is a Red Flag Sign described by Quinn for the diagnosis of idiopathic parkinsonism. Some patients with parkinson s disease may eventually become totally dependent and wheel chair bound, unable to stand unaided or to support an erect posture when sitting. This degree of disabilities is usually only found during the 'off ’ phases of motor fluctuations. The so called wheel chair sign of permanent dependency is more commonly associated with causes of parkinsonism other than Parkinson s disease. 538
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Wheel chair sign of Quinn is used as a typical red flag sign in - (NBE/DNB Pattern) a) Idiopathic parkinsonism b) Duchenne muscular dystrophy c) Becker’s dystrophy d) Thomson disease A 539
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Most frequently asked questions on Parkinsonism Resting tremors which diminishes with movement (4-7 h3).
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  • Winter '16
  • jean grey

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