Parkinsonism: A Review-of-Systems Approach to Diagnosis

Atypical parkinsonian disorders may be initially misdiagnosed as Parkinson's disease. The number and complexity of atypical parkinsonisms seem to be increasing. This, along with the lack of diagnostic tests, makes it difficult for the clinician to distinguish between disease types. It then becomes necessary to assess patients in multiple areas through a review-of-systems approach. An approach of this kind can be used for initial diagnosis, monitoring, refinement of diagnosis, and disease management. This article discusses some of the clinical features for a review-of-systems assessment. Using this approach may allow earlier detection of atypical parkinsonisms, leading to better management of symptoms. KEYWORDS Parkinson's disease - atypical parkinsonisms - progressive supranuclear palsy - dementia with Lewy bodies - multiple system atrophy - corticobasal degeneration - vascular parkinsonism - medication-induced parkinsonism - normal pressure hydrocephalus