To the physical exam, we found facial hypomimia, hypophonia, and hypoacusia.He had bradykinesia, impaired and insecure gait with short steps and slouched posture, with his trunk bent forward, absent arm swing and decomposition of quality of turning.Increased muscle tone with symmetrical cog wheel rigidity in all four extremities were also noted, but reflexes were normal.He also presented resting tremor with wrist flexion-extension that interfered with writing.He was disoriented in time, apathic and hypoprosexic.