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Parkinson's Disease — SCE Neurology MCQ

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HardMovement DisordersParkinson's DiseaseSCE Neurology

A 63-year-old man presents with a 2-year history of progressive bradykinesia, rigidity, and rest tremor affecting the right side more than the left. He has reduced arm swing on the right. There is no postural instability, cognitive impairment, or autonomic failure. What is the most likely diagnosis?

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Correct answer: B — Parkinson's disease

The best answer is “Parkinson's disease”. Parkinsonian syndromes are distinguished by tempo, symmetry, eye movements, falls, autonomic and cognitive features; treatment is individualised to motor and neuropsychiatric burden. The alternatives “Multiple system atrophy”, “Progressive supranuclear palsy”, “Corticobasal degeneration”, “Drug-induced parkinsonism” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG71 Parkinson disease recommendations: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations