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1 results

  • Chapter 34 - Vascular Parkinsonism

  • from Section 2: - Hypokinetic Movement Disorders
  • Edited by Erik Ch. Wolters, Universität Zürich, Christian R. Baumann, Universität Zürich
  • Book:
    International Compendium of Movement Disorders
    Published online:
    07 January 2025
    Print publication:
    06 February 2025, pp 414-422

  • Summary

    Vascular parkinsonism (VP) is a clinical entity within the broader context of parkinsonian syndromes and usually manifests with an array of clinical features including a mainly lower body motor parkinsonism with a gait disorder, corticospinal and pseudobulbar signs and symptoms, urinary incontinence, dementia, and pyramidal and cerebellar signs. As the name suggests, etiologically VP may be defined as a secondary parkinsonian syndrome occurring in relation to ischemic cerebrovascular disease. Treatment for VP remains challenging as available data on the efficacy of current treatment options are contentious. VP is generally considered to be poorly responsive to levodopa, the most effective of the current treatment modalities for parkinsonism; however, there is evidence that some patients benefit from therapy with levodopa, especially in case of underlying ischemic or hemorrhagic lesions in the substantia nigra, globus pallidus pars externa, thalamic ventral lateral nuclei, or nigrostriatal pathway, leading to presynaptic dopamine transporter deficiency as measured by single photon emission computed tomography.