{"ops":[{"insert":"A 65 year old gentleman presents with difficulty in walking for 1 year, forgetfulness for 6 months and urinary incontinence for 5 months. These problems have progressed slowly over time.\n\nThe difficulties in walking included hesitation in initiating steps, slowness in gait, and difficulty in turning around corners. He use to freeze at times while walking.\n\nHe also had difficulty in finding words and handling money, and started forgetting recent events and names of distant relatives.\n\nHe was diagnosed with hypertension 5 years ago, which is well controlled on atenolol. His medical history is otherwise unremarkable.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-184_en.png"}},{"insert":"\n"}]}
2
Investigate
MRI Brain
{"ops":[{"insert":"There is symmetric dilatation of all ventricles; the Evans\u0027 Index is 0.44. The sulci are preserved and perihippocampal fissures are normal. There are no significant white matter abnormalities.\n"}]}
CSF Tap Test
{"ops":[{"insert":"50 ml of CSF drained. \nOpening pressure: 190 mm of water.\nMMSE following Tap test: 27\/30; velocity of gait: faster\n"}]}