A general physical exam revealed a blood pressure of 122 mm Hg / 76 mm Hg and a pulse of 88. She had a very thin appearance,
as her weight was 37 kg. Examination of the chest, heart, and abdomen failed to reveal any abnormalities. Neurological exam
demonstrated pupils that were equal, round and reactive to light and accommodation. She had difficulty with smooth pursuit
and lateral saccades, and showed an overshooting and nystagmus on rapid movements of the eyes. Facial movements were symmetrical
and facial sensation was intact. Hearing and vision were grossly unimpaired. Motor exam showed minimal weakness, but no atrophy
or fasciculations were noted. Reflexes were symmetrical with no pathological reflexes and sensation was intact. She was noted
to have abnormalities of coordination of hand movements, increases blinking, slurred speech, bradykinesia, dysdiadochokinesia,
mild rigidity and adnormal gait with veering to the right. No adventitial movements were seen during the intial examination.
|