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When Are They Parkinson Disease?

Irene Litvan, MD

JAMA. 1998;280:1654-1655.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Parkinsonian syndromes can be classified into 2 major groups: Parkinson disease (PD) and atypical parkinsonian disorders. Common characteristics include akinesia, expressed as slowness and paucity of movement (eg, decreased arm swing or facial expression) and difficulty in initiating movement, and are associated with rigidity with or without resting tremor. Parkinsonian syndromes frequently occur in the elderly, their prevalence increasing markedly with age (14.9% at the age of 65 to 74 years; 52.4% at the age of 85 years or older).¹ The most common parkinsonian syndrome, PD affects approximately one half million Americans. The incidence of PD is about 10 times that of atypical parkinsonian disorders.^2-3

Diagnosis of PD was thought to be straightforward, but 3 recent large clinicopathologic studies showed that specialists misdiagnosed 25% to 40% of patients followed up in practice or assessed after reading detailed clinical vignettes.^4-6 Misdiagnosis by nonspecialists is likely to be even . . . [Full Text of this Article]

Clinical History

Neurologic Examination

Diagnostic Criteria

Other Studies

Features Suggestive of Atypical Parkinsonian Disorders

From the Neuropharmacology Unit, Defense and Veteran Head Injury Program, Henry M. Jackson Foundation, and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md.

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