Parkinson's disease (PD): miscellaneous motor features

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Parkinson's disease (PD): miscellaneous motor features. These are present early in almost 90% of cases. Fully referenced neurology checklist.

Mirror movements

  • These are present early in almost 90% of cases
  • They are mainly in the upper limbs
  • They manifest in the less severely affected side
  • They are tested by repetitive or alternating finger/hand movements of finger tapping
  • They are also a feature of corticobasal degeneration (CBD)

Postural instability and gait difficulty (PIGD)

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Marionette gait (silly walk)

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Sleep-related falling out of bed: risk factors

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Acute akinetic collapse

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Blepharoclonus

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Falls

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Dystonia

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Stroke risk

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References

  1. Espay AJ, Li J-Y, Johnston L, Chen R, Lang AE. Mirror movements in parkinsonism: evaluation of a new clinical sign. JNNP 2005; 76:1355-1359.
  2. Lenfeldt N, Holmlund H, Larsson A, Birgander R, Forsgren L. Frontal white matter injuries predestine gait difficulties in Parkinson's disease. Acta Neurol Scand 2016; 134:210-218. 
  3. van der Heeden JF, Marinus J, Martinez-Martin P, Rodriguez-Blazquez C, Geraedts VJ, van Hilten JJ. Postural instability and gait are associated with severity and prognosis of Parkinson disease. Neurology 2016; 86:2243-2250.
  4. Gu Q, Huang P, Xuan M, et al. Greater loss of white matter integrity in postural instability and gait difficulty subtype of Parkinson's disease. Can J Neurol Sci 2014; 41:763-768. 
  5. Avenali M, Vaghi G, De Icco R, et al. Pearls & Oy-sters: Marionette walk in Parkinson's disease: a rare dyskinetic-dystonic gait pattern complication improved by visual cueing. Neurology 2022; 99:77-81.
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