Tremor | Symmetrical; post 4–8 Hz; arms, head, voice; no latency | Asymmetrical; post 4–8 Hz, rest 3–5 Hz; arms and legs, jaw, eyelids; latency to onset | Asymmetrical; post 4–8 Hz, rest 3–5 Hz; arms or legs; latency | Uncommon | Asymmetrical; postural, with stimulus sensitive myoclonus |
Rigidity | Occasional cogwheel | Asymmetrical; limb | Asymmetrical; limb | Symmetrical; axial >limb | Asymmetrical; limb |
Finger movements | Slow but fixed amplitude | Progressive slowing with decreasing amplitude | Progressive slowing with decreased amplitude | Spared early | Early apraxia—hand can become useless |
Facies | Normal | Early loss of expression and blinking. Late blepharoclonus | Early loss of expression; facial dyskinesias | Lid retraction; staring; eye opening apraxia | Early loss of expression; orobuccal apraxia |
Dysautonomia | None | Early impotence, late OH, bladder, constipation | Early OH, bladder, impotence, constipation | Early impotence, bladder, OH rare | Early impotence, bladder, OH rare |
Bulbar | None | Late dysarthria; hypophonia | Early dysarthria, dysphagia; night stridor | Early dysarthria, dysphagia | Early dysarthria, dysphagia |
Gait and posture | Normal | Late falls; retropulsion; festination, flexed posture | Early falls, flexed posture; antecollis ++ | Early falls, retrocollis | Early falls |
Eye movements | Normal | Hypometric | Nystagmus, hypometric | Eye deviation to OKN, SGP | Occasional SGP |
Ataxia | None | None | Frequent | Rare | Rare |
Apraxia | None | None | None | End stage limb; eye opening | Limb, alien phenomena |