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NATIONAL INSTITUTE OF MENTAL HEALTH AND NEURO SCIENCES(Deemed University) Bangalore-29 Consultants: Prof.P.Satish Chandra/Prof.Dr.Nalini.A. /Prof.Dr.Pramod Kumar pal / Dr. Ravi Yadav/ Dr.M.NethravathiDISCHARGE SUMMARY | Name: | Sarojkumar Patnaik | Address: - Pubusahi VillageKhurda Orissa. | Age/sex: | 46yrs/ male | | Neuro number | N 661442 | | Date of admission: | 13/06/2013 | | Date of discharge | 22/06/2013 | | Diagnosis: | Parkinsosn’s Disease | | Result: | Improved | | History | Patient was apparently normal till 1987 when he developed behavioral symptoms for which he consulted local psychiatrist and was diagnosed for bipolar disorder and advised anti psychotic drugs. Symptoms subsided and again relapsing. Details of the same not available. Since 2002 patient developed insidious onset resting tremors over the hands. h/o slowness of activities of daily living present. Patient was diagnosed for parkinson’s disease in 2008 and started on syndopa and it showed some relief for 3-4 hours but developed dyskinesias. H/O slowness of activities of daily living, change in the voice, frequent hesitancy present. No H/O falls/freezing gait. No H/o anosmia. No h/o bowel disturbance. No h/o sleep disturbance, psychotic delusions. Not a known hypertensive or diabetic.No family history of similar illness. | Examination | BP(mm/Hg) | 130/80 (supine)1240/80(standing) | PR (bpm) | 90 | RR(cpm) | 14 | Temp | Afebrile | General physical examination | Hypomimia present | CVS/RS/PA | NAD | CNS | Patient is conscious & oriented. There is monotonus speech with slurring character. Pupils are BERL. EOM normal. Normal saccades and pursuits. Blink rate is 18/s. Rigidity is present in B/L UL & LL peripheral more than axial. Mild bradykinesia present in all 4 limbs. Postural tremors present along with rest tremors. No head thrust present. Power in all 4 limbs is 5/5. Signs of cerebellar in coordination absent.