Skip to main content Accessibility help
×
Home

Clinical Manifestations of Parkinson's Disease and Parkinsonism

  • Doug Everett Hobson (a1)

Abstract

The most common disorder in a patient presenting to a movement disorder clinic will be parkinsonism. The challenge is to provide the patient with the most accurate diagnosis and prognosis possible. The assumption at the time of initial presentation of the clinical diagnosis of Parkinson's disease is often wrong (20-25%). Waiting to see the pattern of progression, and response to medication provides invaluable additional information. This manuscript summarizes the clinical manifestations of Parkinson's disease and the main akinetic-rigid syndromes (progressive supranuclear palsy, multiple system atrophy, cortical-basal ganglionic degeneration, and dementia with Lewy bodies) that make up the differential diagnosis.

RÉSUMÉ

La majorité des patients d’une clinique des troubles du mouvement prénte du parkinsonisme. Le dé est de poser le diagnostic et de dérminer le pronostic avec le plus de présion possible. La prémption d’un diagnostic clinique de maladie de Parkinson au moment de la consultation initiale est souvent erroné(20 à5% des cas). Des informations suppléntaires préeuses peuvent éner de l’élution de la maladie et de la rénse àa mécation. Cet article prénte un sommaire des manifestations cliniques de la maladie de Parkinson et des principaux syndromes akineto-rigides (paralysie supranuclére progressive, atrophie multisystéque, dénéscence cortico-basale et dénce à corps de Lewy) faisant partie du diagnostic difféntiel.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Clinical Manifestations of Parkinson's Disease and Parkinsonism
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Clinical Manifestations of Parkinson's Disease and Parkinsonism
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Clinical Manifestations of Parkinson's Disease and Parkinsonism
      Available formats
      ×

Copyright

References

Hide All
1. Parkinson, J. In: Sherwood, , Neely, and Jones, , (Eds). An Essay on theShaking Palsy. London: Whittingham and Rowland, 1817.
2. Barbeau, A. Parkinson’s disease: clinical features and etiopathology. In: Vinken, , Bruyn, , Klawans, , (Eds). Vol. 49, Extrapyramidal Disorders. Handbook of Clinical Neurology. Amsterdam: Elsevier Science Publishers, 1996: 87152.
3. Rajput, AH. Clinical features and natural history of Parkinson’sdisease (Special Consideration of Aging): In: Calne, DB,(Ed.) Neurodegenerative Diseases. Philadelphia: W.B. Saunders Company, 1996: 555571.
4. Weiner, WJ, Nora, LM, Glantz, RH. Elderly inpatients: postural refleximpairment. Neurology 1984; 34: 945947.
5. Shahani, BT, Young, RR. Physiological and pharmacologic aids inthe differential of tremor. J Neurol Neurosurg Psychiatry 1976; 39:772783.
6. Lance, JW, Schwab, RS, Peterson, EA. Action tremor and thecogwheel phenomenon in PD. Brain 1963; 86: 95110.
7. Tiffin, J. Purdue Pegboard. Chicago: Scientific Research Association(II), 1941.
8. Wall, JC, Bell, C, Campbell, S, Davis, J. The timed get-up-and-go testrevisited: measurement of the component tasks. J Rehabil Res Dev 2000; 37(1): 109113.
9. Weiner, WJ, Lang, AE. Parkinson’s Disease. In: Weiner, , Lang, (Eds.) Movement Disorders a Comprehensive Survey. New York: Futura Publishing Company, 1989: 23115.
10. Traub, MM, Rothwell, JC, Marsden, CD. Anticipatory posturalreflexes in PD and other akinetic rigid syndromes. Brain 1980; 103: 393412.
11. Rajput, AH, Rozdilsky, B, Rajput, A. Accuracy of clinical diagnosisin parkinsonism – a prospective study. Can J Neurol Sci 1991; 18: 275278.
12. Colcher, A. Clinical manifestations of Parkinson’s disease. Med Clin North Am 1999; 83(2): 327347.
13. Hughes, AJ, Daniel, SE, Lees, AJ. Improved accuracy of clinicaldiagnosis of Lewy body Parkinson’s disease. Neurology 2001; 57(8): 14971499.
14. Richardson, JC, Steele, J, Olszewski, J. Supranuclear opthalmoplegia,pseudobulbar palsy, nuchal dystonia and dementia. Trans Am Neurol Assoc 1963; 88: 2527.
15. Agid, Y, Javoy-Agid, F, Ruberg, M, et al. Progressive supranuclearpalsy: anatomoclinical and biochemical considerations. In: Yahr, MD, Bergman, KI, (Eds.) Parkinson’s Disease. Volume 45, Advances in Neurology. New York: Raven Press, 1987 191206.
16. Pfaffenbach, DD, Layton, DD, Kearns, TP. Ocular manifestations inprogressive supranuclear palsy. Am J Opthalmol 1972; 74: 11791184.
17. Barr, AN. Progressive supranuclear palsy. In: Vinken, , Bruyn, , Klawans, (Eds.) Extrapyramidal Disorders, Vol 49, Handbook of Clinical Neurology. Amsterdam: Elsevier Science Publishers, 1996: 239254.
18. Jackson, JA, Jankovic, J, Ford, J. Progressive supranuclear palsy: clinical features and response to treatment in 16 patients. Ann Neurol 1983; 13: 273278.
19. Masucci, EF, Kurtzke, JF. Tremor in progressive supranuclear palsy. Acta Neurol Scand 1989; 80: 296300.
20. Maher, ER, Smith, EM, Lees, AJ. Cognitive deficits in the Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). J Neurol Neurosurg Psychiatry 1985; 48: 12341239.
21. Pahwa, R. Parkinson’s disease and parkinsonian syndromes; progressive supranuclear palsy. Med Clin N Am 1999; 83(2): 367369.
22. Golbe, LI, Davis, PH. Progressive supranuclear palsy. In: Jankovic, J, Tolosa, E, (Eds.) Parkinson’s Disease and Movement Disorders. Baltimore: Williams and Wilkins, 1988: 121130.
23. Dickson, DW. Neuropathology of Alzheimer’s disease and otherdementias. Clin Geriatr Med 2001; 17(2): 209228.
24. Litvan, I, Agid, Y, Calne, D, et al. Clinical research criteria for thediagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP International workshop. Neurology 1996; 47: 19.
25. Papp, M, Kahn, J, Lantos, P. Glial cytoplasmic inclusions in the CNSof patients with multiple system atrophy (striatonigral degeneration, olivopontocerebellar atrophy and Shy-Drager syndrome). J Neurol Sci 1989; 94: 79100.
26. Wenning, GK, Tison, F, Ben Shlomo, Y, Daniel, SE, Quinn, NP. Multiple system atrophy: a review of 203 pathologically provencases. Mov Disord 1997; 12: 133147.
27. Gilman, S, Low, P, Quinn, N, et al. Consensus on the diagnosis of MSA. J Neurol Sci 1999; 163: 9498.
28. Wenning, GK, Ben Shlomo, Y, Magalhaes, M, et al. Clinical featuresand natural history of multiple system atrophy: an analysis of 100cases. Brain 1994; 117: 835845.
29. Mark, MH. Lumping and splitting the Parkinson Plus syndromes: dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and cortical-basal ganglionicdegeneration. Neurol Clin 2001; 19(3): 607627.
30. Pramstaller, P, Wenning, GK, Smith, SJM, et al. Nerve conductionstudies, skeletal muscle EMG, and sphincter EMG in multiple system atrophy. J Neurol Neurosurg Psychiatry 1995; 58: 618621.
31. Hughes, AJ, Colosimo, C, Kleedorfer, B, et al. The dopaminergicresponse in multiple system atrophy. J Neurol Neurosurg Psychiatry 1992; 55: 10091013.
32. Grimes, DA, Lang, AE, Bergeron, CB. Dementia as the most commonpresentation of the cortical-basal ganglionic degeneration. Neurology 1999; 53(9): 19691974.
33. Ribeiz, JJ, Kolodny, EH, Richardson, EP. Corticodentatonigraldegeneration with neuronal achromasia. Arch Neurol 1968; 18: 2033.
34. Feany, MB, Mattiace, LA, Dickson, DW. Neuropathologic overlap ofprogressive supranuclear palsy, Pick’s disease, and corticobasal ganglionic degeneration. J Neuropathol Exp Neurol 1996; 55: 5367.
35. Frattali, CM, Grafman, J, Patronas, N, et al. Language disturbances incorticobasal degeneration. Neurology 2000; 54; 990992.
36. Litvan, I, Cummings, JL, Mega, M. Neuropsychiatric features ofcorticobasal degeneration. J Neurol Neurosurg Psychiatry 1998; 65: 717721.
37. Lang, AE, Riley, DE, Bergeron, C. Cortical-basal ganglionic degeneration. In: Calne, DB (Ed.). Neurodegenerative Diseases. Philadelphia: W.B. Saunders, 1994; 877894.
38. Rinne, JO, Lee, MS, Thompson, PD, et al. Corticobasal degeneration: a clinical study of 36 cases. Brain 1994; 117: 11831196.
39. Kertesz, A, Martinez-Lage, P, Davidson, W, et al. The corticobasaldegeneration syndrome overlaps with progressive aphasia and frontotemporal dementia. Neurology 2000; 55: 13681375.
40. Kosaka, K. Lewy bodies in cerebral cortex: report of three cases. Acta Neuropathol 1978; 42: 127134.
41. Ballard, C, Harrison, RWS, Lowery, K, KcKeith, I. Non-cognitivesymptoms in Lewy body dementia. In: Perry, R, McKeith, I, Perry, E. (Eds.) Dementia with Lewy Bodies. Cambridge, UK: Cambridge University Press, 1996: 6784.
42. Olichney, JM, Galasko, D, Salamon, DP, et al. Cognitive decline isfaster in Lewy body variant than in Alzheimer’s disease. Neurology 1998; 51: 351357.
43. Salmon, DP, Galasko, D, Hansen, LA, et al. Neuropsychologicaldeficits associated with diffuse Lewy body disease. Brain Cogn 1996; 31: 148165.
44. Galasko, D, Katzman, R, Salmon, DP. Clinical and neuropathologicalfindings in Lewy body dementia. Brain Cogn 1996; 31: 176185.
45. Louis, ED, Klata, LA, Lui, Y, et al. Comparison of extrapyramidalfeatures in 31 pathologically confirmed cases of diffuse Lewy body disease and 34 pathologically confirmed cases of Parkinson’s disease. Neurology 1997; 48: 376380.
46. de Bruin, VMS, Lees, AJ, Daniel, SE. Diffuse Lewy body diseasepresenting with supranuclear gaze palsy, parkinsonism, and dementia: a case report. Mov Disord 1992; 7: 355358.
47. McKeith, IG, Galasko, D, Kosaka, K, et al. Consensus guidelines forthe clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the international workshop. Neurology 1996; 47(5): 11131124.
48. Mouradian, MM. Recent advances in the genetics and pathogenesisof Parkinson’s disease. Neurology 2002; 58(2): 179185.
49. Ching, KH, Westaway, SK, Gitschier, J, Higgins, JJ, Hayflick, SJ. HARP syndrome is allelic with pantothenate kinase-associated neurodegeneration. Neurology 2002; 58(11) 16731674.
50. Canadian Pharmacists Association In: Repchinsky, C (Ed.). Compendium of Pharmaceuticals and Specialties. 37th Ed 2002. Ottawa: Canadian Pharmacists Association. 2002.

Clinical Manifestations of Parkinson's Disease and Parkinsonism

  • Doug Everett Hobson (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed