QuestionSBA
QuestionChoice
Parkinson's disease is a chronic neurological disorder characterised by the loss of dopaminergic neurons in the substantia nigra. This results in impairment of basal ganglia function and subsequent motor dysfunction. BMJ classify the classic triad of Parkinson's features as bradykinesia, rest tremor, and rigidity and these symptoms manifest as a consequence of basal ganglia impairment.
10000346
a
Bradykinesia, rest tremor, rigidity
QuestionChoice
Although these are all potential features of Parkinson's disease, these are atypical symptoms of early disease. Indeed, NICE suggest that symptoms such as recurrent falls and severe autonomic dysfunction may suggest a diagnosis of a different cause of parkinsonism, such as multiple system atrophy or progressive supranuclear palsy.
10000347
b
Bradykinesia, autonomic dysfunction, recurrent falls
QuestionChoice
These symptoms indicate a "Parkinson's plus" diagnosis of Lewy body dementia. Lewy body dementia and Parkinson's disease have a close but complicated relationship and so it is important to differentiate the two. The BMJ recommend as a general rule that Parkinson's disease with dementia is diagnosed if Parkinson's was diagnosed at least 1 year before dementia onset and that Lewy body dementia should be diagnosed if dementia is present at symptom onset or within 1 year of parkinsonism onset.
10000348
c
Cognitive impairment, bradykinesia, visual hallucinations
QuestionChoice
This is the clinical triad of Wernicke's encephalopathy, a neurological condition caused by vitamin B1 (thiamine) deficiency.
10000350
e
Altered mental status, gait ataxia, ophthalmoplegia
QuestionChoice
This is the classical clinical triad of normal pressure hydrocephalus, not Parkinson's disease. This is an important diagnosis to be aware of as it is one of the few reversible causes of dementia.
10000349
d
Dementia, urinary incontinence, gait abnormalities
Concept
Chapter
2693
3747
Parkinson's Disease
Topic
141
Neurology
12616
A 66-year-old male presents to general practice as he has noticed changes in his movement. You suspect Parkinson's disease and refer him to neurology for specialist input.

Which of the following best characterises the classic triad of Parkinson's symptoms?
a