Cardinal signs of Parkinsons disease

What are the cardinal signs of Parkinsons disease? 

Tremor, bradykinesia, rigidity, and impairment in postural reflexes are the four cardinal signs of PD. 

Tremor at rest is one of the most typical signs of parkinsonism. It is characterized by an oscillatory pronation–supination at a 3- to 5-Hz frequency.

In addition to the hands, where it assumes an appearance of pill rolling, this type of tremor is commonly observed in the facial musculature (lips and chin) as well as in the legs.

Head tremor, however, is rare in parkinsonism, and its presence should suggest the diagnosis of essential tremor (ET).

The term bradykinesia is used to describe slowness of movements that often causes difficulties for the patients in getting dressed, feeding, and maintaining personal hygiene.

Bradykinesia is evident when a patient performs rapid alternating movements, such as pronation and supination of the forearms. 

Rigidity , often associated with the cogwheel phenomenon, is another hallmark of parkinsonism. 

Impairment of the postural reflexes is responsible for the falls that are frequently experienced by parkinsonian patients.

Parkinsonian gait often reflects a combination of bradykinesia, rigidity, and postural instability. 

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