Rule Out / Past cases / Parkinson disease
Rule Out case #9 · GentleParkinson disease: a six-clue practice case
Read the clues in order and name the diagnosis as early as you can. Clues move from the patient’s story to the classic findings.
Play it as a game firstGuess before each clue unlocks, then share your score.The clues
Clue 1: A 67-year-old man's wife says he has “slowed down” over the past year.
Clue 2: It came on so gradually that neither of them can say when it started.
Clue 3: He lost his sense of smell years ago, and he acts out his dreams in his sleep.
Clue 4: His right hand trembles at rest and stops when he reaches for a cup; his steps are small and shuffling.
Clue 5: His wrist has ratchet-like stiffness, his face shows little expression, and his handwriting has shrunk.
Clue 6: His symptoms improve clearly on levodopa.
Show the diagnosis and takeaways
What gives it away
- Resting tremor, slowness (bradykinesia) and rigidity are the core motor signs.
- It comes from loss of dopamine-producing neurons in the substantia nigra.
- A clear response to levodopa supports the diagnosis.
Ran as Rule Out #9 (Monday, October 26, 2026).
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