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Four motor symptoms are considered cardinal signs in PD: slowness of movement (bradykinesia), tremor, rigidity, and postural instability. [1] Typical for PD is an initial asymmetric distribution of these symptoms, where in the course of the disease, a gradual progression to bilateral symptoms develops, although some asymmetry usually persists.
Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia (slowed movements), rigidity, and postural instability. [1] [2] Both hypokinetic (bradykinesia and akinesia) as well as hyperkinetic (cogwheel rigidity and tremors at rest) features are displayed by Parkinsonism. [3]
As 90 percent of Parkinson's cases are sporadic, the identification of the risk factors that may influence disease progression or severity is critical. [ 116 ] [ 68 ] The most significant risk factor in developing PD is age, with a prevalence of 1 percent in those aged over 65 and approximately 4.3 percent in age over 85. [ 117 ]
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Since Parkinson’s disease is a progressive disease, patient’s symptoms continue to worsen with time and they often develop visible differences in their walking that greatly affects their quality of life. These differences include shuffling of steps, decreased stride length, and decrease in overall movement.
Pyramidal signs can be a result from different types of damage to the brain or spinal cord, such as strokes, infections, tumors, hemorrhagic events, multiple sclerosis, or trauma. [ 4 ] Parkinsonian-Pyramidal syndrome (PPS) is a combination of both pyramidal and parkinsonian signs that manifest in various neurodegenerative diseases.