parkinson plus syndrome

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Introduction

Differentiated from Parkinson's disease by the presence of additional signs & symptoms.

Clinical manifestations

Laboratory

* also see Parkinson's disease

Differential diagnosis

Distinguishing features of Parkinson's disease (PD), progressive supranuclear palsy (PSP) & Shy-Drager syndrome

sign/symptom PD PSP Shy-Drager
bradykinesia 3+ 3+ 3+
rigidity 3+ 3+ 3+
tremor 3+ 1+ 1+
autonomic dysfunction 2+ 1+ 4+
pyramidal signs 0 1+ 0
cerebellar signs 0 1+ 2+
supranuclear gaze palsy 0 3+ 0
response to Sinemet + - -

* PSP: progressive supranuclear palsy

* PD: Parkinson's disease

Management

  • generally unresponsive to Sinemet[2]
  • prognosis
    • rapid progression
    • death within 8-12 years[2]

More general terms

More specific terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1051
  2. 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018, 2021
  3. 3.0 3.1 Pereira JB, Kumar A, Hall S et al DOPA decarboxylase is an emerging biomarker for Parkinsonian disorders including preclinical Lewy body disease. Nat Aging 2023. Sept 18 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37723208 https://www.nature.com/articles/s43587-023-00478-y

Patient information

parkinson plus syndrome patient information