Family Nurse Practitioner Exam

Which clinical sign is not associated with Parkinson's disease?

1. Pill-rolling tremor

2. Difficulty initiating involuntary movement

3. Shuffling gait with cogwheel rigidity

4. Increased facial movements due to tics

The correct answer is: Increased facial movements due to tics

In the context of Parkinson's disease, increased facial movements due to tics is not a characteristic clinical sign. Parkinson's disease is primarily associated with motor symptoms that include resting tremors, such as the classic pill-rolling tremor, and bradykinesia, which refers to the difficulty in initiating voluntary movements. Other hallmark signs include rigidity, often described as cogwheel rigidity, and a shuffling gait, which reflects difficulties in maintaining smooth and coordinated movement. Facial expressions in Parkinson's disease can actually be diminished, leading to a condition known as "masked facies" rather than increased movements. Tics, on the other hand, are sudden, repetitive movements or sounds that are typically associated with different neurological or psychological conditions, such as Tourette's syndrome. Hence, the presence of tics and increased facial movements distinguishes these conditions from Parkinson's disease, emphasizing that tics are not a feature of the disorder.