Parkinson syndrome (paralysis agitans; shaking palsy)

General: Late stages of epidemic encephalitis; present with arter 616g61g iosclerosis and with manganese and carbon monoxide poisoning; widespread destruction of pigmented cells in substantia nigra.

Ocular: Decreased blinking; lid fluttering; blepharospasm; oculogyric crises; ocular hypotony; blepharoplegia; ptosis; nystagmus; paralysis of convergence; paralysis of lateral rectus muscle; absent or sluggish pupillary reactions to light or convergence; mydriasis or anisocoria; optic neuritis; papilledema; abnormal saccades.

Clinical: Slowness of movements; loss of facial expression; 'cogwheel' rigidity of the arms; rhythmical tremors; drooling; shuffling gait; stooping; monotonous voice.

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Guiloff RJ, et al. Reversible supranuclear ophthalmoplegia associated with parkinsonism. J Neurol Neurosurg Psychiatry 1980; 44:552-554.

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Shimizu N, et al. Eye-head co-ordination in patients with parkinsonism and cerebellar ataxia. J Neurol Neurosurg Psychiatry 1981; 44:509-515.