Movement Disorder Program Kane Hall Barry Neurology Bedford/Keller Halim Fadil, MD: Movement Disorder Neurologist Susan Imke, FNP: Gerontological Nurse Practitioner In partenership with: Abdolreza Siadati, MD,DBS Neurosurgeon Fort Worth Brain and Spine Institute
Neurology Residency: LSU Shreveport, LA • Neurophysiology Fellowship: UC Davis • Movement Disorders Fellowship: Cedars-Sinai Medical Center, Los Angeles, CA With Dr. Michele Tagliati
An Essay on The Shaking Palsy “Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; With a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.” James Parkinson, 1817.
Clinical Features of PD Four cardinal signs • Bradykinesia (Slowness) • Muscle rigidity (Stiffness) • Resting tremor • Postural instability Characteristic traits • Asymmetric onset • Masked face • Micrographia • Low volume speech • Flexed posture • Shuffling and festinating gait • Response to levodopa
Non-Motor Symptoms of PD Sleep Disorders • Insomnia • Sleep Fragmentation • Parasomnias • Restless Legs Syndrome • PLMS • Excessive daytime sleepiness • Sleep attacks Sensory • Loss of sense of smell • Pain • Paresthesias • Altered sensation • Restless legs Psychiatric • Dementia • Hallucinations • Delirium • Mood Disturbance • Depression • Agitation • Anxiety and Panic Attacks Autonomic • Orthostatic Hypotension • Constipation • Urinary problems • Sexual problems • Sweating and Thermoregulation