Mr. N, age 66 years, has noticed excessive fatigue, muscle aches, and weakness in his legs for some time.

Mr. N, age 66 years, has noticed excessive fatigue, muscle aches, and weakness in his legs for some time. His hands were shaking slightly, although his wife reported that the shaking appeared to stop when he fell asleep. Some unintentional head movements were also apparent. He remembers that his grandfather died in his mid-60s after suffering for years from a condition with similar symptoms. After several tests and the elimination of some other neuromuscular conditions, a diagnosis of Parkinson’s disease was made for Mr. N.

1. Discuss the pathophysiology of Parkinson’s disease and how it differs from other neuromuscular conditions affecting older adults. (See Parkinson’s Disease.)

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2. Discuss the usual progression of the disease as the pathophysiology develops further. Indicate additional manifestations that will be noticeable. (See Parkinson’s Disease—Signs and Symptoms.)

3. Describe the complications that frequently develop, including the rationale for each and the early indications of each problem.

4. Discuss the treatments available to this patient. (See Parkinson’s Disease—Treatment.)