Dramatic Weight Loss in a Patient With Parkinson Disease

Heidi Moawad, MD

Disclosures

July 25, 2019

Physical Examination and Workup

The patient appears to be well-nourished, despite his recent weight loss. He is alert and oriented and in no acute distress. He has dry, flaky skin, as is commonly seen with Parkinson disease-associated seborrheic dermatitis. Otherwise, his skin appears normal. His heart sounds are normal, his respiration is normal, and his abdomen is nondistended and nontender. His blood pressure is 160/85 mm Hg, and his pulse is 86 beats/min.

Upon neurologic examination, the patient's mental status and affect are normal. He is able to recall his medical history with great detail. His speech is clear, and he speaks rapidly in a monotone voice. He does not have any tremors during the examination.

The patient's extraocular movements are intact, with no nystagmus. He does not have any visual field cut. His pupils are symmetrical and reactive to light, and he does not have papilledema. He does not have facial asymmetry, and his facial sensation is normal.

His muscle tone is increased in all four extremities, and his strength is 5/5 in all four extremities. His sensory examination is normal, and his reflexes are normal. He has a shuffling gait but is able to walk without difficulty.

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