Clinical Findings

The Parkinson's-Reversing Breakthrough

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The onset of symptoms of Parkinson's disease is usually gradual. The most prominent features of parkinsonism are tremor, rigidity, and bradykinesia, although the time of onset and the relative severity of each symptom may differ in individual patients. Tremors are often unilateral in onset, present at rest, and cease during voluntary movement. Rigidity, or increased muscle tone, de scribed as jerky resistance that has been likened to the movement of a cogwheel (cogwheel rigidity), is also an indication of altered motor control. Bradykinesia, an extreme slowness of movement, is the most disabling feature because it affects all motor systems. Brady-kinesia results in a typical stooped posture when the person is standing or walking and a characteristic shuffling gait marked by the absence of normal arm-swinging movements. The absence of facial expression (masklike face) results from loss of facial muscle function. Inability to swallow leads to drooling, while bradyki-nesia of the muscles in the larynx results in changes in voice quality. Orthostatic hypotension may also be observed and may complicate therapy. Cognitive dysfunction and dementia are also seen in a small percentage of Parkinson's disease patients, especially the elderly.

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