Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive history of resting tremor, bradykinesia, and rigidity. Onset was insidious, starting unilaterally. Reports difficulty with fine motor tasks, micrographia, and shuffling gait. No history of neuroleptic use or atypical features (e.g., early autonomic failure, vertical gaze palsy).
Clinical Examination Findings
Patient appears alert and oriented. Vitals stable. General physical exam unremarkable except for masked facies (hypomimia) and infrequent blinking. No orthostatic hypotension noted upon standing.
Treatment Protocol
Initiate Levodopa/Carbidopa titration. Consider Dopamine Agonists (e.g., Pramipexole) for younger patients. Physical therapy referral for gait training and balance exercises. Monitor for motor fluctuations and dyskinesia.