Halim Fadil, MD : Movement Disorder Neurologist

1. Movement Disorder Program Kane Hall Barry Neurology Bedford/Keller Halim Fadil, MD: Movement Disorder Neurologist Susan Imke, FNP: Gerontological Nurse Practitioner In partenership with: Abdolreza Siadati, MD,DBS Neurosurgeon Fort Worth Brain and Spine Institute

3. Neurology Residency: LSU Shreveport, LA • Neurophysiology Fellowship: UC Davis • Movement Disorders Fellowship: Cedars-Sinai Medical Center, Los Angeles, CA With Dr. Michele Tagliati

4. An Essay on The Shaking Palsy “Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; With a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.” James Parkinson, 1817.

5. Clinical Features of PD Four cardinal signs • Bradykinesia (Slowness) • Muscle rigidity (Stiffness) • Resting tremor • Postural instability Characteristic traits • Asymmetric onset • Masked face • Micrographia • Low volume speech • Flexed posture • Shuffling and festinating gait • Response to levodopa

6. Non-Motor Symptoms of PD Sleep Disorders • Insomnia • Sleep Fragmentation • Parasomnias • Restless Legs Syndrome • PLMS • Excessive daytime sleepiness • Sleep attacks Sensory • Loss of sense of smell • Pain • Paresthesias • Altered sensation • Restless legs Psychiatric • Dementia • Hallucinations • Delirium • Mood Disturbance • Depression • Agitation • Anxiety and Panic Attacks Autonomic • Orthostatic Hypotension • Constipation • Urinary problems • Sexual problems • Sweating and Thermoregulation

7. Constipation

8. Uncontrolled loss of stool

9. Nausea/Vomiting

10. Bladder dysfunction

11. Changes in taste and smell

12. Unexplained pain

13. Unexplained changes in weight

14. Cognitive impairment and dementia

15. Hallucinations

16. Depression

17. Orthostatic hypotension

18. Sexual dysfunction

19. Insomnia

20. REM sleep behavior disorder

21. Thank you