diagnostic criteria for Parkinson's disease

Introduction

Parkinson's disease is a clinical diagnosis. Inclusionary criteria:

• clinical criteria alone sufficient
  • bradykinesia* + at least one of the following:
    • resting tremor (or with movement)
    • cogwheel rigidity
    • postural reflex impairment#
• pharmacologic criteria
  • beneficial response to L-dopa (L-dopa/carbidopa Sinemet)

* decrements in speed & amplitude of repetitive movements (dysdiadochokinesia) qualifies as bradykinesia

# orthostatic hypotension is exclusionary

Exclusionary criteria:

• parkinsonism due to:
  • trauma
  • brain tumor
  • infection
  • cerebrovascular disease
  • other known neurologic disease
  • drugs or toxins (MPTP)
• oculomotor palsy
• cerebellar signs
• vocal cord paresis
• orthostatic hypotension
• pyramidal signs
• amyotrophy
• MRI finding of striatal hypointensity

Notes

• early falls is an atypical feature
• sometimes a clear diagnosis cannot be made for a few years after the disorder presents itself.

More general terms

• criteria

Additional terms

• Parkinson's disease (paralysis agitans, PD)