Fortnightly Review: Parkinsonism--recognition and differential diagnosis

BMJ 1995;310:447-452 (18 February)

Education and debate

Fortnightly Review: Parkinsonism--recognition and differential diagnosis

Niall Quinn, reader in clinical neurology ^a

^a Institute of Neurology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG

Summary points

The cumulative lifetime risk of a person developing parkinsonism has been estimated at 1 in 40
Idiopathic Parkinson's disease is the commonest cause, but about a third of patients with the syndrome of parkinsonism or a diagnosis of Parkinson's disease have some other disease instead
The diagnosis of Parkinson's disease is entirely clinical, but the results of certain investigations may help in recognising alternative causes for parkinsonism
For a diagnosis of established parkinsonism, upper body akinesia must be present; rigidity is usually, but not always, present; tremor is an optional extra
The two conditions that are most commonly misdiagnosed as Parkinson's disease--essential tremor and arteriosclerotic pseudoparkinsonism--do not display true parkinsonism

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Diagnosis and treatment of Parkinson's disease: C M Hawkes
BMJ 1995 310: 1668. [Extract] [Full Text]

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