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Clinical Manifestations of Parkinson's Disease and Parkinsonism

Published online by Cambridge University Press:  02 December 2014

Doug Everett Hobson
Doug Everett Hobson*
Affiliation:
University of Manitoba, Department of Medicine, Winnipeg, MB, Canada
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Abstract

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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

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.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 30 , supplement S1: A Peer-Reviewed Supplement to the Canadian Journal of Neurological Sciences , February 2003 , pp. S2 - S9
Copyright
Copyright © The Canadian Journal of Neurological 2003

References

1. Parkinson, J. In: Sherwood, , Neely, and Jones, , (Eds). An Essay on theShaking Palsy. London: Whittingham and Rowland, 1817.Google Scholar
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: 87–152.Google Scholar
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: 555–571.Google Scholar
4. Weiner, WJ, Nora, LM, Glantz, RH. Elderly inpatients: postural refleximpairment. Neurology 1984; 34: 945–947.Google Scholar
5. Shahani, BT, Young, RR. Physiological and pharmacologic aids inthe differential of tremor. J Neurol Neurosurg Psychiatry 1976; 39:772–783.Google Scholar
6. Lance, JW, Schwab, RS, Peterson, EA. Action tremor and thecogwheel phenomenon in PD. Brain 1963; 86: 95–110.Google Scholar
7. Tiffin, J. Purdue Pegboard. Chicago: Scientific Research Association(II), 1941.Google Scholar
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): 109–113.Google Scholar
9. Weiner, WJ, Lang, AE. Parkinson’s Disease. In: Weiner, , Lang, (Eds.) Movement Disorders a Comprehensive Survey. New York: Futura Publishing Company, 1989: 23–115.Google Scholar
10. Traub, MM, Rothwell, JC, Marsden, CD. Anticipatory posturalreflexes in PD and other akinetic rigid syndromes. Brain 1980; 103: 393–412.Google Scholar
11. Rajput, AH, Rozdilsky, B, Rajput, A. Accuracy of clinical diagnosisin parkinsonism – a prospective study. Can J Neurol Sci 1991; 18: 275–278.Google Scholar
12. Colcher, A. Clinical manifestations of Parkinson’s disease. Med Clin North Am 1999; 83(2): 327–347.Google Scholar
13. Hughes, AJ, Daniel, SE, Lees, AJ. Improved accuracy of clinicaldiagnosis of Lewy body Parkinson’s disease. Neurology 2001; 57(8): 1497–1499.Google Scholar
14. Richardson, JC, Steele, J, Olszewski, J. Supranuclear opthalmoplegia,pseudobulbar palsy, nuchal dystonia and dementia. Trans Am Neurol Assoc 1963; 88: 25–27.Google Scholar
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 191–206.Google ScholarPubMed
16. Pfaffenbach, DD, Layton, DD, Kearns, TP. Ocular manifestations inprogressive supranuclear palsy. Am J Opthalmol 1972; 74: 1179–1184.Google Scholar
17. Barr, AN. Progressive supranuclear palsy. In: Vinken, , Bruyn, , Klawans, (Eds.) Extrapyramidal Disorders, Vol 49, Handbook of Clinical Neurology. Amsterdam: Elsevier Science Publishers, 1996: 239–254.Google Scholar
18. Jackson, JA, Jankovic, J, Ford, J. Progressive supranuclear palsy: clinical features and response to treatment in 16 patients. Ann Neurol 1983; 13: 273–278.Google Scholar
19. Masucci, EF, Kurtzke, JF. Tremor in progressive supranuclear palsy. Acta Neurol Scand 1989; 80: 296–300.Google Scholar
20. Maher, ER, Smith, EM, Lees, AJ. Cognitive deficits in the Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). J Neurol Neurosurg Psychiatry 1985; 48: 1234–1239.CrossRefGoogle ScholarPubMed
21. Pahwa, R. Parkinson’s disease and parkinsonian syndromes; progressive supranuclear palsy. Med Clin N Am 1999; 83(2): 367–369.Google Scholar
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: 121–130.Google Scholar
23. Dickson, DW. Neuropathology of Alzheimer’s disease and otherdementias. Clin Geriatr Med 2001; 17(2): 209–228.Google Scholar
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: 1–9.CrossRefGoogle Scholar
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: 79–100.Google Scholar
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: 133–147.Google Scholar
27. Gilman, S, Low, P, Quinn, N, et al. Consensus on the diagnosis of MSA. J Neurol Sci 1999; 163: 94–98.Google Scholar
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: 835–845.Google Scholar
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): 607–627.CrossRefGoogle Scholar
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: 618–621.Google Scholar
31. Hughes, AJ, Colosimo, C, Kleedorfer, B, et al. The dopaminergicresponse in multiple system atrophy. J Neurol Neurosurg Psychiatry 1992; 55: 1009–1013.Google Scholar
32. Grimes, DA, Lang, AE, Bergeron, CB. Dementia as the most commonpresentation of the cortical-basal ganglionic degeneration. Neurology 1999; 53(9): 1969–1974.CrossRefGoogle ScholarPubMed
33. Ribeiz, JJ, Kolodny, EH, Richardson, EP. Corticodentatonigraldegeneration with neuronal achromasia. Arch Neurol 1968; 18: 20–33.CrossRefGoogle Scholar
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: 53–67.Google Scholar
35. Frattali, CM, Grafman, J, Patronas, N, et al. Language disturbances incorticobasal degeneration. Neurology 2000; 54; 990–992.Google Scholar
36. Litvan, I, Cummings, JL, Mega, M. Neuropsychiatric features ofcorticobasal degeneration. J Neurol Neurosurg Psychiatry 1998; 65: 717–721.Google Scholar
37. Lang, AE, Riley, DE, Bergeron, C. Cortical-basal ganglionic degeneration. In: Calne, DB (Ed.). Neurodegenerative Diseases. Philadelphia: W.B. Saunders, 1994; 877–894.Google Scholar
38. Rinne, JO, Lee, MS, Thompson, PD, et al. Corticobasal degeneration: a clinical study of 36 cases. Brain 1994; 117: 1183–1196.Google Scholar
39. Kertesz, A, Martinez-Lage, P, Davidson, W, et al. The corticobasaldegeneration syndrome overlaps with progressive aphasia and frontotemporal dementia. Neurology 2000; 55: 1368–1375.Google Scholar
40. Kosaka, K. Lewy bodies in cerebral cortex: report of three cases. Acta Neuropathol 1978; 42: 127–134.Google Scholar
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: 67–84.Google Scholar
42. Olichney, JM, Galasko, D, Salamon, DP, et al. Cognitive decline isfaster in Lewy body variant than in Alzheimer’s disease. Neurology 1998; 51: 351–357.Google Scholar
43. Salmon, DP, Galasko, D, Hansen, LA, et al. Neuropsychologicaldeficits associated with diffuse Lewy body disease. Brain Cogn 1996; 31: 148–165.Google Scholar
44. Galasko, D, Katzman, R, Salmon, DP. Clinical and neuropathologicalfindings in Lewy body dementia. Brain Cogn 1996; 31: 176–185.Google Scholar
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: 376–380.CrossRefGoogle ScholarPubMed
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: 355–358.Google Scholar
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): 1113–1124.Google Scholar
48. Mouradian, MM. Recent advances in the genetics and pathogenesisof Parkinson’s disease. Neurology 2002; 58(2): 179–185.Google Scholar
49. Ching, KH, Westaway, SK, Gitschier, J, Higgins, JJ, Hayflick, SJ. HARP syndrome is allelic with pantothenate kinase-associated neurodegeneration. Neurology 2002; 58(11) 1673–1674.Google Scholar
50. Canadian Pharmacists Association In: Repchinsky, C (Ed.). Compendium of Pharmaceuticals and Specialties. 37th Ed 2002. Ottawa: Canadian Pharmacists Association. 2002.Google Scholar