Parkinson's Disease, Parkinsons Disease, Parkinsons Syndrome, Parkinson's Syndrome

Parkinsonism
DIFFERENTIAL DIAGNOSIS OF PARKINSON'S DISEASE

Parkinson's disease is an idiopathic, relentlessly progressive, neurologic disorder manifested clinically by tremor, bradykinesia, rigidity, and postural instability. In addition to these four cardinal signs, there are many motor and nonmotor manifestations of Parkinson's disease, including cognitive, sensory, and autonomic disturbances. Within Parkinson's disease, there are different subgroups with relatively specific clinical patterns.

Secondary parkinsonism is thought to represent 8.2% of all our parkinsonian patients. The causes include environmental exposure (e.g., drugs or toxins) and other factors(trauma, metabolic derangement, infection, stroke, brain tumor). 'Lower body' parkinsonism, a condition in which upper body motor function is relatively preserved while gait is markedly impaired, is often associated with multiple lacunar infarctions and may represent one form of vascular parkinsonism. (Fitzgerald PM, Jankovic J: Lower body parkinsonism: Evidence for vascular etiology. Mov Disorders 4:249, 1989)

The symptoms that are reviewed in making a differential diagnosis among the various types of Parkinsonism are:

  • Bradykinesia
  • Rigidity
  • Gait disturbance
  • Tremor
  • Ataxta
  • Dysautonomia
  • Dementia
  • Dysarthria/
  • dysphagia
  • Dystonia
  • Eyelid apraxia
  • Limb apraxia
  • Motor neuron
  • disease
  • Myoclonus
  • Neuropathy
  • Oculomotility
  • disturbance
  • Orthostatic
  • hypotension
  • Sleep abnormal
  • Asymmetric find
  • Levodopa response The various types of Parkinsonism's include:
  • Primary (idiopathic) parkinsonism
  •   Parkinson's disease
  •   Juvenile parkinsonism
  • Secondary (acquired,symptomatic) parkinsonism
  •   infectious: postencephalitic, slow virus
  •   Drugs:dopamine receptor blocking drugs (antipsychotic. antiemetic drugs), reserpine, tetrabenazine, alpha-methyl-dopa, lithium. flunarizine, cinnarizine
  •   Toxins:MPTP, CO, Mn, Hg. CS2, methanol, ethanol
  •   Vascular:multi-infarct
  • Trauma:pugilistic encephalopathy
  •   Other:parathyroid abnormalities, hypothyroidism. hepatocerebral degeneration. brain tumor, normal pressure hydrocephalus. syringomesencephatia
  • Heredodegenerative parkinsonism
  •   Huntington's disease
  •   Wilson's disease
  •   Hallervorden-Spatz disease
  •   Olivopontocerebellar and spinocerebellar degenerations
  •   Familial basal ganglia calcification
  •   Familial parkinsonism with peripheral neuropathy
  •   Neuroacanthocytosis
  • Multiple system degenerations (parkinsonism plus)
  •   Progressive supranuclear palsy
  •   Shy-Drager syndrome
  •   Striatonigral degeneration
  •   Parkinsonism-dementia-ALS complex
  •   Corticobasat ganglionic degeneration
  •   Autosomal dominant Lewy body disease
  •   Alzheimer's disease
  • PARKINSON'S DISEASE and Manganese Exposure
    Parkinson's Disease from Welding?

    DO I HAVE A MANGANSIM CASE?
    Manganism symptoms / Parkinsonism

    (c) Copyright 2004 Monheit Law: Manganism Section