Case Study 1: Michael J. Fox

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Headshot of Dawn Elise DeWitt, MD, MSc, CMedEd, MACP, FRACP, FRCP-London · Senior Associate Dean, Collaboration for InterProfessional Health Education Research & Scholarship (CIPHERS)
Dawn Elise DeWitt
MD, MSc, CMedEd, MACP, FRACP, FRCP-London · Senior Associate Dean, Collaboration for InterProfessional Health Education Research & Scholarship (CIPHERS)
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Case Study 1: Michael J. Fox

As you watch these videos, notice the physical manifestations of PD and his medication/treatment. Make a list of your “physical examination” findings.

 Drug-induced parkinsonism

Note

Removal of drug will reverse symptoms.

Commonly cause PD sx
  • Antipsychotics
  • Haloperidol, chlorpromazine
  • Risperidone, olanzapine, ziprasidone, aripiprazole
  • Antiemetics
  • Metoclopramide
  • Prochlorperazine
  • Dopamine depleters
  • Tetrabenazine, reserpine
PD sx uncommon
  • Mood stabilizers
  • Lithium
  • Valproic acid
  • Other
  • Amiodarone
  • Flunarizine
  • SSRIs
  • Screen for falls: “Pull test” is best predictor.
    • Pull shoulders from behind; fall or >2 corrective steps is diagnostic.
    • Assess for other reasons for falls.
  • Screen for depression: Differentiate from “apathy.”
    • Decreased motivation without emotional distress.

 

Team care is important to address functional issues; supports and fall prevention are important.