On examination you find the following:
- Speech – quiet
- HMF – normal
- Cranial nerves – normal
- ULs – resting tremor on right hand side; goes away when moves and then comes back again
- Tone – increased R > L
- Power – normal
- Reflexes – normal
- LLs – normal
- Gait – slow; reduced arm swing on right
So what have you got?
Basically, you have a hypokinetic movement disorder characterised by tremor, increased tone and a reduction in arm swing on walking.
I have left out one thing here – what VITAL piece of the puzzle is missing?
And here is how to examine it.
So you will be unsurprised to hear that this is Parkinson’s disease. There is a list of other options but this story is most consistent with PD.
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