Hi everyone, this is the last update of the patient with Parkinsonian tremor.

FAQs at the bottom.

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RECAP: 72-year-old male with a 9-month history of "Parkinsonian tremor" that was intermittent, right-sided, and large-amplitude, with a flexion pattern affecting the upper extremity more than the lower. Cervical retraction-extension abolished the right upper- and lower-extremity tremor during the session, and this improvement was maintained at subsequent follow-up. His only recurrence occurred during phone use and fine motor tasks. He is weaning off L-DOPA.

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UPDATE: MRI Results

Disc space heights: Preserved

C1-2: Unremarkable.

C2-3: No significant disc herniation, foraminal stenosis or spinal canal stenosis.

C3-4: Mild disc bulge. Right uncovertebral degenerative changes. Moderate bilateral facet arthropathy. Moderate left foraminal stenosis. Severe right foraminal stenosis. No central canal stenosis.

C4-5: No disc herniation. Severe right facet arthropathy and mild left facet arthropathy. Moderate left foraminal stenosis. Severe right foraminal stenosis. No central canal stenosis.

C5-6: Mild disc bulge. Moderate bilateral facet arthropathy. Moderate-severe bilateral foraminal stenosis. No central canal stenosis.

C6-7: Mild disc bulge. Severe right and moderate-severe left foraminal stenosis. No central canal stenosis.

C7-T1: No significant disc herniation, foraminal stenosis or spinal canal stenosis.

IMPRESSION:

• No acute osseous injury of the cervical spine.
• Cervical spine spondylosis as described above.

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TAKEAWAY: The tremor has not returned, and all activity has normalized. He never had a Parkinsonian tremor. He did have a mechanical upper motor neuron disruption. He is golfing again, has returned to the gym with his usual workouts, and is really happy-he brought us donuts 😊.

• 5 Sessions
• 4 Secured messages
• 3 HEP updates
• 2 Donuts
• 1 Happy patient

FOTO Med. Neuro. scores: 59 on Intake, 97 on Discharge

Until next time,

Ryan Tauzell, PT, Cert. MDT

ryan@atlashealth.io

​atlashealth.io​

PS: Thanks to everyone who is emailing me to chat about these patients! I really enjoy the conversations and "comparing notes".

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