(D) Preserved postural reflexes # In Parkinsonism the postural reflexes are not preserved. There is difficulty in maintaining balance, the posture is stopped and the attitude is flexed.# Clinical features of Parkinsonism> General: Masked face Stuped posture/flexed attitude Slurred indistinct speech> Bradykinesia Difficulty/slowness in initiating voluntary movements> Gait postures Difficulty in maintaining balance Rapid short steps, tendency to run (festinant gait) Difficulty in stopping suddenly Reduced swinging of arms> Tremors:> Resting 4-6 hzs Diminish with movement and attention Fingers most commonly affected> Postural 8-10 hzs Persist on movement> Rigidity Lead pipe (more in lower limbs and trunk) Cog wheel (more in upper limb)> Others Normal deep tendon reflexes Flexor plantar response (negative Babiniski) Normal intelligence Small handwriting Emotional lability# Clinical Features of Parkinson's Disease:> A diagnosis of PD can be made with some confidence in patients who present with at least two of the three cardinal signs - rest tremor, rigidity, and bradykinesia.> Tremor is particularly important, as it is present in 85% of patients with true PD;> Masked facies, decreased eye blinking, stooped posture & decreased arm swing complete the early picture.> Vague feeling of weakness and fatigue, incoordination aching, and discomfort may also herald the onset.> Rest tremor, at a frequency of 4 to 6 Hz, typically and wrist where it may have a 'pill-rolling' character.> Abnormalities of balance and posture tend to increase in prominence as the disease progresses.> Flexion of the head, stooping, and posture while walking are common, as are changes in the posture of the fingers and hands.> Postural instability is one of the most disabling to major morbidity and mortality.