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Brought to you by the Resident and Fellow Section of Neurology®.
September 5, 2012
First described by Dr. Frederic Hanes in 1943, the Hanes Sign, or Whistle–Smile Reflex, is an aid to the clinical diagnosis of parkinsonian syndrome. When a normal patient is asked to whistle, he or she does so and then gives a sheepish grin due to the "absurdity of unmotivated whistling" (1). As a feature of facial paucity, the parkinsonian patient does not smile after whistling is completed. This reportedly reliable sign serves as a useful clinical clue for parkinsonism in addition to the cardinal motor features of Parkinson disease: tremor at rest, rigidity, bradykinesia, and gait and balance difficulty (2).
Submitted by Jonathan M. Beary, D.O. & Dimitrios A. Nacopoulos, M.D.
Disclosure: Drs. Beary and Nacopoulos report no disclosures.
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