Physical Exam Resources for Parkinson's Disease
A Guide for Medical Learners
Parkinson’s disease is a complex neurological condition that impacts more than 10 million people worldwide — and it is becoming even more prevalent. According to the Parkinson’s Foundation, it is estimated that 1.1 million Americans are currently living with the disease and 90,000 people are diagnosed with Parkinson’s each year.
While there is currently no cure for Parkinson’s, there are various medications, therapies and treatments that can help relieve symptoms and improve quality of life. Early diagnosis and intervention are important, as they may help reduce symptoms and slow disease progression.
Without a definitive diagnostic test for Parkinson's disease, diagnosis depends on careful clinical evaluation of patient history, physical findings, and symptoms. The following notes and Stanford Medicine 25 resources aim to help medical learners recognize and diagnose this common neurological condition.
An Overview of Parkinson’s Disease
Parkinson’s disease is a “progressive movement disorder of the nervous system” that causes deterioration of the brain’s nerve cells (neurons), according to the National Institute of Neurological Disorders and Stroke. It is generally characterized by challenges in movement, tremor, stiffness and balance that may contribute to difficulty walking, talking or performing simple tasks.
Parkinson’s is also the fastest growing neurological disorder in the world, according to authors of the 2018 paper, “The Emerging Evidence of the Parkinson Pandemic,” published in the Journal of Parkinson’s Disease. The authors make the case that although Parkinson’s is non-infectious, it “exhibits many of the characteristics of a pandemic,” because it is found across a large expanse of geographic areas and is increasing in every major region. The authors state that from 1990 to 2015, the number of people with Parkinson’s disease doubled.
Quick Facts About Parkinson's Disease
Here are some essential facts from the Parkinson’s Foundation that provide helpful context about the disease:
- Parkinson’s disease is the second-most common neurodegenerative disease after Alzheimer's disease.
- Age is the primary risk factor for Parkinson’s.
- Men are 1.5 times more likely to have Parkinson's disease than women.
- Incidence rates of Parkinson’s are higher in certain areas, such as the American Rust Belt.
- Exact causes of Parkinson’s are unknown, but scientists believe that a combination of genetic and environmental factors are at play.
- Early signs of Parkinson’s include tremor, small handwriting, loss of smell, trouble sleeping, trouble moving or walking, constipation, a low or soft voice, masked face, dizziness or fainting, a stooped or hunched posture and more.
Stanford Medicine 25 Resources on Parkinson’s Disease
Stanford Medicine 25 has several resources related to the physical exam for Parkinson’s disease, which are outlined below.
- Our guide to the physical exam for Parkinson’s disease reviews key exam aspects including inspection, bradykinesia, rigidity, tremor and gait and balance abnormalities. See it here.
- This video featuring Stanford neurologist Kathleen Poston, MD, MS, demonstrates the exam to diagnose and monitor progression of Parkinson's disease.
- This article describes involuntary movements, including tremor, which are commonly associated with Parkinson’s disease.
- This outline of the cerebellar exam provides important insights on neurological evaluation.
- This overview of gait abnormalities explores eight pathological gaits that can be attributed to neurological conditions, including the Parkinsonian gait.
These materials can help medical learners develop the clinical skills necessary to recognize Parkinson's disease early and provide better care for the millions of patients affected by this growing neurological condition.
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