Quiz: The symptoms and signs of Parkinson's disease, have you mastered all these questions?

Parkinson's disease is one of the most common neurological diseases
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Two hallmark neuropathological findings of the disease are the loss of pigmented dopaminergic neurons in the substantia nigra pars compacta and the presence of Lewy bodies and Lewy neurites
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More than 6 million people worldwide have been diagnosed with Parkinson's disease
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Its incidence and prevalence increase with age, with an average age of about 60 years
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Parkinson's disease is 1.
5 times more common in men than women, a trend that may increase with age
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In most populations, 3%-5% of Parkinson's disease is associated with a known Parkinson's disease gene, representing monogenic Parkinson's disease
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Can you correctly identify the signs and symptoms of Parkinson's disease? This article will test everyone's understanding through 5 small questions, let's try it together
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Compiled and organized by Yimaitong, please do not reprint without authorization
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Question 1 In the process of early clinical diagnosis of Parkinson's disease, which one is the classic symptom? A.
Postural balance disorder B.
Kinesiology tremor C.
Bradykinesia D.
Postural tremor Figure 1 Scroll to see the answer↓↓↓↓↓↓↓↓↓【Answer and Analysis】Answer:
C.

There are four hallmark signs of Parkinson's disease
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To make a clinical diagnosis, patients must exhibit two of these three symptoms: resting tremor, rigidity, and bradykinesia
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The fourth hallmark sign—postural balance disturbance—usually appears late in the course of the disease, at least 8 years later
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To be diagnosed, the patient must meet these core characteristics and respond to dopaminergic therapy
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 Many people with Parkinson's disease also experience some degree of postural and/or motor tremor, although resting tremor is typical of the disease
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Question 2 Which symptoms may precede clinical diagnosis? A.
Loss of smell B.
Aphasia C.
Low voice D.
Abnormal sweating Swipe to see the answer↓↓↓↓↓↓↓↓↓【Answer and Analysis】Answer:
A.

Non-motor symptoms or prodromal/premotor symptoms may appear 10 years before motor symptoms
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These symptoms include hyposmia, anosmia, depression, constipation, REM sleep behavior disorder, visual changes, anxiety, and other autonomic disturbances
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Smell tests may reveal hyposmia, which precedes motor symptoms by years, providing evidence for the onset of Parkinson's disease
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However, loss of smell is not specific and can also occur in Alzheimer's disease
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 When Parkinson's disease has motor symptoms, they are often asymmetrical
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The most common initial sign is resting tremor of the upper extremities
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As the disease progresses, patients develop bradykinesia, stiffness, and difficulty with gait
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The axial stance becomes more curved and the stride becomes shorter
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Postural disturbance is also a sign of Parkinson's disease, but it develops later in the course of the disease
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 Low voice and sweating with other thermoregulation abnormalities are typical symptoms of Parkinson's disease
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Aphasia is not a typical symptom of the disease and can be absolutely ruled out during the diagnosis
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Question 3 Which test may be helpful in diagnosing Parkinson's disease? A.
CTB.
Dopamine transporter SPECTC.
MRID.
Ultrasound slide to see the answer↓↓↓↓↓↓↓↓↓【Answer and Analysis】Answer:
B.

Parkinson's disease is a clinical diagnosis based primarily on motor features (although non-motor symptoms should not be ignored)
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While measurements of cerebrospinal fluid alpha-synuclein aggregates have so far provided encouraging preliminary results, laboratory biomarkers cannot be relied upon for this condition
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And dopamine transporter single photon emission CT (SPECT) can improve the diagnostic accuracy
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Findings from MRI and CT are generally of no value in diagnosing Parkinson's disease, and ultrasound is not sensitive or specific enough for the diagnosis of Parkinson's disease and atypical Parkinson's disease
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Question 4 According to the new diagnostic criteria for Parkinson's disease, which symptoms can exclude Parkinson's disease from the differential diagnosis? A.
Cortical sensory loss B.
Early bulbar dysfunction C.
Isolated plantar extensor muscle response D.
Repeated falls and sliding due to balance disturbance within 1 year of onset See the answer↓↓↓↓↓↓↓↓↓【Answer and Analysis】Answer: A
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The Movement Disorders Society recently released new diagnostic criteria for Parkinson's disease
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Cortical sensory loss was one of nine absolute exclusion criteria according to these guidelines
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Early bulbar dysfunction and repeated falls (caused by impaired balance) within 1 year of onset are red flags for the diagnosis of Parkinson's disease
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No red flags are allowed for patients diagnosed with the disease
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However, if one red flag is present, the patient may be diagnosed with clinically probable Parkinson's disease as long as the supportive criteria are balanced; if two red flags are present, at least two supportive criteria are required
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Question 5 Which symptoms help distinguish Parkinson's disease from atypical Parkinson's disease? A.
Supranuclear palsy of vertical gaze B.
Alloleg phenomenon C.
The tremor is not aggravated during exercise D.
Polymyoclonus minor Swipe to see the answer↓↓↓↓↓↓↓↓↓【Answer and Analysis】Answer:
C.

Early in the course of the disease, differentiating Parkinson's disease from atypical Parkinson's disease (ie, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration) can be a diagnostic challenge, and diagnostic error between Parkinson's disease and essential tremor rate is high
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Resting tremor does occur in essential tremor, but it amplifies during movement -- a sign not found in Parkinson's disease
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 Supranuclear palsy of vertical gaze is a common symptom of progressive supranuclear palsy but does not occur in Parkinson's disease
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Heteropodism is one of the most common features of corticobasal degeneration
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In multiple system atrophy, the tremor is usually convulsive rather than static, with polymyoclonus minor
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Compiled from: Rajesh Pahwa.
Fast Five Quiz: Signs and Symptoms of Parkinson's Disease - Medscape - Jan 13, 2022.