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Parkinson's disease — SCE Neurology MCQ

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EasyMovement DisordersParkinson's diseaseSCE Neurology

A 66-year-old man has 18 months of slowness, smaller handwriting and reduced right arm swing. Examination shows asymmetric bradykinesia, cogwheel rigidity and a right resting tremor. Eye movements are normal and there is no early autonomic failure or cerebellar ataxia. What is the most likely diagnosis?

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Correct answer: B — Parkinson's disease

Parkinson's disease is the best answer. Asymmetric bradykinesia with rigidity and resting tremor, without early atypical features, is typical Parkinson's disease. PSP gives early falls and vertical gaze palsy; MSA has prominent autonomic/cerebellar features; essential tremor is action tremor; drug-induced parkinsonism is often symmetric with dopamine-blocker exposure. Clinical pearl: Bradykinesia is the core motor feature, not tremor alone.

Reference: NICE NG71