Parkinsonian syndromes

Abstract

A variety of conditions may cause parkinsonian syndromes independent of the idiopathic loss of substantia nigra neurons and deafferentation of the striatum; these include degenerative conditions, infections, drugs, toxins and structural lesions (Figure 2.1). The clinical pictures of these degenerative conditions overlap but are usually recognized by the presence of subtle red flags in the earlier stage of the illness. Over the period of a few years a distinctive atypical clinical picture, separate to that of Parkinson's disease, emerges and is typically characterized by a poorer response to dopaminergic therapy. However, it may be impossible to distinguish idiopathic Parkinson's disease from other parkinsonian syndromes by clinical features alone, although review of the patient's medical history and diagnostic tests, such as sophisticated neuroimaging, can aid diagnosis [1]. © Springer-Verlag London Limited 2010.