Parkinsonism

Age of onset over 58 years

Slow onset

 Clinical features

Tremor—pill-rolling

Rigidity- Cogwheel

Bradykinesia

Mask like face

Monotonous speech

Micrographic

Poor balance

Constipation

Postural hypotension

 Diagnosis

Clinical diagnosis

Management options

Referral to Neurologist

Screening for depression

Occupational therapist input/referral

Pharmacological

Dopaminergic release (Levodopa, carbidopa)

Dopamine agonist (Bromocriptine, Cabergoline)

Anticholinergics (Benzhexol, benztropine)

COMT inhibitors (Entacapone)

Others

Amantadine

Selegiline