Cogwheel rigidity

Rigidity is muscular stiffness throughout the range of passive movement in a limb segment. Cogwheel rigidity, which is typical for parkinsonism, means that tremor is superimposed on muscle stiffness. 

In this case, a more careful psychiatric and physical examination can be of help. Although there are admitted similarities to depression and the negative symptoms of schizophrenia, Parkinson s disease is also associated with a resting tremor, called cogwheel rigidity, and at times drooling. These other symptoms are not typically due to psychiatric illness. If these symptoms are present, one should investigate the possibility of a medication side effect or the presence of Parkinson s disease. 

Extrapyramidal signs such as cogwheel rigidity have been reported with therapeutic doses. 

Although its adverse effect profile is similar to that of other NSAIDs in most ways, flurbiprofen is also associated rarely with cogwheel rigidity, ataxia, tremor, and myoclonus. 

Shopsin, B., Gershon, S. (1975). Cogwheel rigidity related to lithium maintenance. American Journal of Psychiatry, 132, 536—538. 

Once a stable chronic model has been established,the affected primates exhibit a typical Parkinsonian syndrome, for which a variety of behavioral measures have been developed. These include neurological descriptions of symptoms typical of human PD including action and resting tremor, cogwheel rigidity, postural impairments, hypokinesia and... 

Occasionally, long-term use of lithium is associated with cogwheel rigidity and a parkinsonian tremor (189). More often than not, concurrent or past treatment with an antipsychotic drug is involved. In a review of SSRI-induced extrapyramidal adverse effects, lithium was listed, but not discussed, as a possible risk factor (190). A review of drug-induced parkinsonism provided references to case reports of lithium s occasionally inducing or exacerbating parkinsonism (191). 

A 24-year-old woman with mental retardation and an unspecified psychosis took risperidone 2 mg/day and trihexyphenidyl 2 mg/day and after 2 weeks developed symptoms that included tilting of her body backwards and to the left and tremors and cogwheel rigidity of the limbs (101). Risperidone was withdrawn and olanzapine 5 mg/day started after 4 weeks there was no improvement and she was then lost to follow-up. 

However, in a recent report, extrapyramidal symptoms of classic muscle stiffness and cogwheel rigidity at the elbow occurred during the crash phase of a 40-year-old man s cocaine withdrawal (132). 

A 38-year-old Caucasian woman, who had taken heroin vapor 2 weeks before, developed confusion, ataxia, and urinary incontinence. She was afebrile and spoke with a slow low-volume monotonous voice. She had marked truncal ataxia with absent postural reflexes, cogwheel rigidity in her limbs, and marked bradykine-sia. She had used non-prescription amfetamine up to 4 g/day intermittently for 8 years. After a bout of depression, she came under the care of a psychiatrist and stopped taking amfetamine after she was given chlorpromazine and diazepam. She then started using... 

The effects of cocaine or its withdrawal on neurotransmitter activity have been evaluated in several studies. Although changes in dopaminergic activity appear to be associated with early cocaine abstinence, extrapyramidal symptoms (due to alterations in dopamine functioning) have only infrequently been reported in cocaine users. However, in a recent report, extrapyramidal symptoms of classic muscle stiffness and cogwheel rigidity at the elbow occurred during the crash phase of a 40-year-old man s cocaine withdrawal (95). 

Parkinson s Disease affects a half million Americans. Symptoms include tremor (pill-rolling) at rest, bradykinesia (slow movements), and cogwheel rigidity. 

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