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Atypical Parkinsonian Disorders pp 409–429Cite as

Role of Electrophysiology in Diagnosis and Research in Atypical Parkinsonian Disorders

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Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Correct clinical diagnosis of patients with parkinsonism is not always possible in spite of the continuous effort in defining diagnostic criteria (1). Parkinsonism, defined as the combination of bradykinesia and rigidity (2), may be a predominant clinical feature of several diseases, including idiopathic Parkinson’s disease (IPD) and several other entities commonly known as “Parkinson-plus” syndromes or atypical parkinsonian disorders (APDs). In these entities, parkinsonism is accompanied by other clinical signs, or red flags (3), that should warn the physician of the existence of a degenerative disorder. Even though rather specific clinical patterns have been described in patients with APDs, such as predominantly autonomic failure, cerebellar, or pyramidal dysfunction, in multiple system atrophy (MSA), axial rigidity, ocular motility disorders, and falls early in the course of the disease, in progressive supranuclear palsy (PSP), myoclonus and asymmetrical higher cortical limb dysfunction, in corticobasal degeneration (CBD), and fluctuating cognitive deficits, visual hallucinations, and REM sleep behavior disorder, in diffuse Lewy-body disease (LBD), these signs are not always evident or they may pass unrecognized by nonspecialized neurologists. In some conditions, such as for instance CBD, similar clinical expressions may be common to different pathologies (4), and the same disease may encompass diverse clinical presentations (5). In others, such as MSA with parkinsonian features (MSA-P), patients may behave like IPD until death (6), making it almost impossible to establish a clinical separation between the two diseases. Nowadays, the definite clinical diagnosis still resides in the pathological postmortem examination (1,7,8).

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  1. Unitat d’EMG, Servei de Neurologia, Departament de Medicina, Hospital Clínic, Institut d’Investigacio Biomedica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain

    Josep Valls-Solé MD

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  1. Josep Valls-Solé MD
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  1. Movement Disorder Program, Department of Neurology, University of Louisville School of Medicine, Louisville, KY

    Irene Litvan MD (Raymond Lee Lebby Professor of Parkinson Disease Research, Director) (Raymond Lee Lebby Professor of Parkinson Disease Research, Director)

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© 2005 Humana Press Inc., Totowa, NJ

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Valls-Solé, J. (2005). Role of Electrophysiology in Diagnosis and Research in Atypical Parkinsonian Disorders. In: Litvan, I. (eds) Atypical Parkinsonian Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-834-X:409

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  • DOI: https://doi.org/10.1385/1-59259-834-X:409

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