Parkinsonism With Atypical Postures

The Parkinson's-Reversing Breakthrough

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Charcot studied muscle tone extensively and established that most Parkinson's disease subjects showed a flexed posture with the shoulders hunched forward, neck bent down toward the chest, and the arms held in partial flexion at rest. In contrast, he found a small number of parkinsonian patients

Parkinsons Disease Posture

Fig. 1. Tremor recording machine used by Charcot to separate cases of typical rest tremor from those with postural tremor and action-induced tremor. Early studies focused on the differentiation by tremor type of multiple sclerosis and Parkinson's disease, but this apparatus was later used to study the various formes frustes of Parkinson's disease as well. In the insert, tremor recordings are shown for resting posture (AB) and action (BC) in patients with different tremor patterns. From Dictionnaire Encyclopédique des Sciences Médicales, 1883.

Fig. 1. Tremor recording machine used by Charcot to separate cases of typical rest tremor from those with postural tremor and action-induced tremor. Early studies focused on the differentiation by tremor type of multiple sclerosis and Parkinson's disease, but this apparatus was later used to study the various formes frustes of Parkinson's disease as well. In the insert, tremor recordings are shown for resting posture (AB) and action (BC) in patients with different tremor patterns. From Dictionnaire Encyclopédique des Sciences Médicales, 1883.

who were bradykinetic, unstable in their stance and gait, and yet showed a very different posture. These subjects, collectively termed "Parkinson's disease with extended posture," were of particular interest to Charcot, and he recognized several features of these cases that distinguished them from the archetypal cases of Parkinson's disease. These cases are further discussed later in the subheading on Progressive Supranuclear Palsy and shared several additional features of this diagnosis including the distinctive facial expression, swallowing difficulties, and frequent falls (Fig. 2).

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