Parkinsonism And Movement Disorders

Since degeneration of the nigrostriatal system occurs in all parkinsonian disorders, drugs targeting the principal transmitter deficiency, DA, remain the treatment of choice for associated motor dysfunction, especially rigidity and bradykinesia. Positron emission tomography (PET) studies have shown decreased striatal 18flourodopa uptake and decreased striatal regional blood flow indicative of the loss of nigral dopaminergic neurons (1,2). Moreover, a preferential loss of postsynaptic DA-D2...

Clinical Examination

The 4-5 Hz tremor is most apparent when the arm is fully relaxed supported and at rest, in an armchair . It is increased by mental calculation and stress and best seen during walking. It is reduced by action and intention tricks used by the patients to hide the tremor . The classical description is the pill-rolling rhythmic alternating opposition of the thumb and forefinger. Some patients have postural tremor in particular conditions holding a phone with a different frequency 6 Hz . This is the...