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Overview of Parkinsonism and Approach to Differential Diagnosis 

Overview of Parkinsonism and Approach to Differential Diagnosis
Overview of Parkinsonism and Approach to Differential Diagnosis

Sabine Spielberger

and Werner Poewe

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date: 22 October 2020

Parkinsonism is one of the most common movement disorders and may be the clinical manifestation of a variety of neurodegenerative, structural, toxic, metabolic, infectious, and vascular disorders. Since therapy and prognosis differ considerably between different forms of parkinsonism, an early correct diagnosis is of great clinical significance but may be challenging on clinical grounds alone.

Ancillary tests for enhancement of diagnostic accuracy include drug-challenge testing to assess dopaminergic responsiveness, neuroimaging to evaluate nigrostriatal pre-synaptic dopaminergic function or evidence for structural abnormalities, and genetic testing to identify common genetic subtypes of Parkinson’s disease. Therapeutic management of parkinsonism mainly depends on the underlying pathology. Levodopa is the single most effective way to treat the motor symptoms of Parkinson’s disease, but it may also be at least partially effective in other types of parkinsonism, so that a trial with levodopa will be part of the treatment approach in most patients presenting with parkinsonism.

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