Parkinsonism – Clinical features

Parkinson’s disease is a neuro degenerative disorder of the central nervous system. The disease affects motor skills, parkinson's diseasespeech and other CNS functions of the patient.

The early signs and symptoms of Parkinsons disease might go unnoticed. They might begin on one side of the body and remain worse on the same side even when the other side has developed the symptoms of Parkinsonism too.

Parkinson’s Disease symptoms

The main clinical features of parkinsonism are:

  • Distal pill-rolling tremor (about 5 Hz)
  • Tremors mainly involve hands
  • Bradykinesia
  • Often unilateral predominance
  • Cogwheel rigidity
  • Emotionless /mask like face expressions
  • Akinesia of face and limbs
  • Impassive facies
  • Drooling
  • Flexed posture
  • Loss of righting reflexes, and imparied balance, with postural instability
  • Autonomic features; e.g. incontinence, postural hypotension

Explanation of signs and symptoms of Parkinsonism

Lets look at details about the signs and symptoms of Parkinson’s disease.

Distal Pill rolling tremors in Parkinson’s disease

The tremors in Parkinsons disease usually begin in limbs, specially hands or fingers. Pill rolling tremors are ones in which the thumb and index finger keep rubbing, like a pill rolling movement. This is a characteristic of Parkinson’s disease when the hand it relaxed (at rest).

Tremors mainly involve hands

The tremors are a sign of Parkinson’s disease, however they mainly involve hands.


Brady kinesia means slowed movement. Gradually, as the disease progresses, the patient with Parkinson’s disease is unable to do even common and simple tasks due to the slowing down of movement. The simple tasks become difficult and time consuming.

The walking style might change and the steps become shorter, even dragging the feet when walking, making it difficult to move around.

It might even become difficult to change your posture, e.g. getting out of chair.

Often unilateral predominance

The symptoms of Parkinson’s disease might appear on one side of body and even remain more on the same side even when the other side gets involved.

Cogwheel Rigidity

The muscles of the patient with Parkinson’s disease get rigid. The stiffness can occur in any part of the body, limiting the range of motion and pain in that part.



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