Part 5 · Neurology II — Spinal Cord, Movement, Cognition and Stroke

79. Parkinson Disease II: Atypical Parkinsonism, Therapy and Safety

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Syndrome	Signature clues
Multiple system atrophy	early autonomic failure, urinary dysfunction, orthostatic hypotension, parkinsonian or cerebellar phenotype
Progressive supranuclear palsy	early falls, axial rigidity, slowed vertical saccades or supranuclear gaze palsy
Corticobasal syndrome	asymmetric rigidity/apraxia, cortical sensory loss, alien limb, myoclonus
Dementia with Lewy bodies	dementia around or before parkinsonism, fluctuations, visual hallucinations, REM-sleep behaviour disorder
Drug-induced parkinsonism	dopamine blockers or depleters; often symmetric but not always

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Syndrome

Signature clues

Multiple system atrophy

early autonomic failure, urinary dysfunction, orthostatic hypotension, parkinsonian or cerebellar phenotype

Progressive supranuclear palsy

early falls, axial rigidity, slowed vertical saccades or supranuclear gaze palsy

Corticobasal syndrome

asymmetric rigidity/apraxia, cortical sensory loss, alien limb, myoclonus

Dementia with Lewy bodies

dementia around or before parkinsonism, fluctuations, visual hallucinations, REM-sleep behaviour disorder

Drug-induced parkinsonism

dopamine blockers or depleters; often symmetric but not always