Movement disorders Quiz: Ace Your Exams
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A 53-year-old man comes to the office because of increased frequency of falls, loss of balance, and blurry vision for the past several months. His partner mentions that the patient has been moodier, has difficulty coming up with names of places, and “gets aggravated easily if he does not get his way.” Vitals are within normal limits. On physical examination, the patient moves slowly and walks with small steps. There is rigidity noted in the extremities, and a fine tremor in the bilateral hands. Eye examination shows a limited upward and downward gaze with slowing of vertical saccades bilaterally. The fundal margins are clear without edema. A therapeutic dose of levodopa is administered and does not result in improvement of the patient’s rigidity or tremors. Which of the following is the most likely diagnosis?
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