Objective: PD is a degenerative disorder of the central nervous system mainly affecting the motor system. In addition to motor symptoms, PD can impair other functions.

Background: A 82-year-old patient was admitted to the hospital with a chief complaint of gait difficulties. History of present illness. The patient was in his usual state of excellent health until 2008 when he developed constipation. In 2009 he had excessive daytome somnolence. Later in 2010 he suffered from insomnia and fatigue. In 2013 he noticed hypersalivation and speech disturbances.

Methods: Complete neurological examination, laboratory analyses, neuroimaging studies and cognitive tests were performed. Neurological examination revealed rest tremor, rigidity, postural instability ,bradykinesia, spasticity and dysarthria. Laboratory tests were within normal ranges. Brain MRI scan was without abnormalities. Patients familiy history for PD was negative.

Results: Based on these findings the diagnosis of PD was suspected and L-DOPA was prescribed. Follow up revealed obvious reduction in bradykinesia, salivation and tremor.

Conclusions: A comprehensive review of a present illness history demonstrates that all of the patients symptoms must be carefully considered and thoroughly analyzed in order to reveal early stages of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-case-of-pd-with-non-motor-symptoms-onset/