Clinical Case Database / Category: Case Based Discussion

Parkinson's disease

Publication details

Edward Richfield
Foundation Years Journal, volume 6, issue 1, p.5 (123Doc Education, London, January 2012)


A 72 year old man attends a general medical clinic with his son. The father has been referred by his General Practitioner with “General Decline”. As the Foundation Year 2 doctor you are asked by your consultant to assess him. You notice that it takes him several minutes to enter the consultation room, and whilst going to assist him you observe a slight shake in his right hand. He has a soft voice, and frequently dabs at the corner of his mouth with a tissue. During the course of the consultation it is apparent that his most troubling symptoms are falls, difficulty being heard and hyper-salivation which he finds embarrassing. You comment on his tremor and his son mentions that they have been concerned about the possibility of Parkinson’s disease.

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Edward Richfield

Specialist Registrar in Geriatric and General Medicine
Yorkshire and Humber Deanery


1. Poewe. W. Non-Motor symptoms in Parkinson’s disease. European Journal of Neurology 2008, 15 (suppl. 1): 14-20
2. Chauduri.K.R. Non-Motor features of Parkinson’s disease. In: Birmingham Movement Disorders Course 2008.
3. Hughed A.J.D aniel S.E, Kilford L, Lees A.J. accuracy of clinical diagnosis of Parkinson’s disease: a clinic-pathalogical study of 100 cases. Journal of Neurol. Neurosurg. Psychiatry 1992; 55: 181-4
4. National Institute for Clinical Excellence Parkinson’s disease Guidelines.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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