ABSTRACT
This chapter presents a case of a 71-year-old ex-cleaner who is brought to the follow-up neurology clinic by her daughter and a carer from the residential home where she resides. She has no history of any other physical or psychiatric illness. She reports her mood to be normal but on direct questioning she becomes tearful, saying she cannot help crying. Cognitive examination reveals impairments in attention span, registration, recall, writing, construction and three-stage command. She is now presenting with lability of mood associated with further deterioration of her cognitive abilities and her movement disorder. This woman has a diagnosis of Parkinson disease (PD), which is being treated with levodopa. She is now presenting with lability of mood associated with further deterioration of her cognitive abilities and her movement disorder. In this case, there are periods of low mood and tearfulness alternating with periods of hyperactivity, agitation and elated mood.
