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Article: Vascular pseudoparkinsonism

TitleVascular pseudoparkinsonism
Authors
Issue Date1992
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ANE
Citation
Acta Neurologica Scandinavica, 1992, v. 86 n. 6, p. 588-592 How to Cite?
AbstractVascular pseudoparkinsonism may be confused with idiopathic Parkinson's disease. Patients may be unnecessarily treated with anti-parkinsonian drugs while their underlying vascular disease is ignored. We investigated 250 parkinsonian patients seen in our Movement Disorders Clinic for a possible vascular etiology. After excluding those with a known secondary cause such as drug-induced parkinsonism, progressive supranuclear palsy, multiple system atrophy and hyperparathyroidism, brain computed tomography and/or magnetic resonance imaging were performed on those who showed poor or no response to levodopa. In those with an ischemic lesion demonstrated on neuroimaging, anti-parkinsonian drugs were stopped and the patients were reassessed. Eleven patients (4.4%) had ischemic brain lesions accounting for their parkinsonism. All were initially diagnosed as Parkinson's disease because of the prominence of bradykinesia and rigidity. Gait disturbance was also common, but resting tremor was distinctly absent. Three anatomical patterns with different prognosis were identified. Three patients with basal ganglia lacunar infarct recovered spontaneously, three with frontal lobe infarcts remained static and five with periventricular and deep subcortical white matter lesions had progressive deterioration. Autopsy in one patient confirmed bilateral frontal lobe watershed infarcts and the absence of brain stem Lewy bodies. Parkinsonian patients with poor or no response to levodopa therapy should be investigated for a vascular etiology.
Persistent Identifierhttp://hdl.handle.net/10722/147926
ISSN
2015 Impact Factor: 2.559
2015 SCImago Journal Rankings: 1.203
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChang, CMen_US
dc.contributor.authorYu, YLen_US
dc.contributor.authorNg, HKen_US
dc.contributor.authorLeung, SYen_US
dc.contributor.authorFong, KYen_US
dc.date.accessioned2012-05-29T06:09:56Z-
dc.date.available2012-05-29T06:09:56Z-
dc.date.issued1992en_US
dc.identifier.citationActa Neurologica Scandinavica, 1992, v. 86 n. 6, p. 588-592en_US
dc.identifier.issn0001-6314en_US
dc.identifier.urihttp://hdl.handle.net/10722/147926-
dc.description.abstractVascular pseudoparkinsonism may be confused with idiopathic Parkinson's disease. Patients may be unnecessarily treated with anti-parkinsonian drugs while their underlying vascular disease is ignored. We investigated 250 parkinsonian patients seen in our Movement Disorders Clinic for a possible vascular etiology. After excluding those with a known secondary cause such as drug-induced parkinsonism, progressive supranuclear palsy, multiple system atrophy and hyperparathyroidism, brain computed tomography and/or magnetic resonance imaging were performed on those who showed poor or no response to levodopa. In those with an ischemic lesion demonstrated on neuroimaging, anti-parkinsonian drugs were stopped and the patients were reassessed. Eleven patients (4.4%) had ischemic brain lesions accounting for their parkinsonism. All were initially diagnosed as Parkinson's disease because of the prominence of bradykinesia and rigidity. Gait disturbance was also common, but resting tremor was distinctly absent. Three anatomical patterns with different prognosis were identified. Three patients with basal ganglia lacunar infarct recovered spontaneously, three with frontal lobe infarcts remained static and five with periventricular and deep subcortical white matter lesions had progressive deterioration. Autopsy in one patient confirmed bilateral frontal lobe watershed infarcts and the absence of brain stem Lewy bodies. Parkinsonian patients with poor or no response to levodopa therapy should be investigated for a vascular etiology.en_US
dc.languageengen_US
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ANEen_US
dc.relation.ispartofActa Neurologica Scandinavicaen_US
dc.subject.meshAgeden_US
dc.subject.meshBasal Ganglia - Pathologyen_US
dc.subject.meshBrain Ischemia - Diagnosis - Pathologyen_US
dc.subject.meshCaudate Nucleus - Pathologyen_US
dc.subject.meshCerebral Infarction - Diagnosis - Pathologyen_US
dc.subject.meshDiagnosis, Differentialen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIntracranial Arteriosclerosis - Diagnosis - Pathologyen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeurologic Examinationen_US
dc.subject.meshNeurons - Pathologyen_US
dc.subject.meshParkinson Disease, Secondary - Diagnosis - Pathologyen_US
dc.subject.meshSubstantia Nigra - Pathologyen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.titleVascular pseudoparkinsonismen_US
dc.typeArticleen_US
dc.identifier.emailLeung, SY:suetyi@hkucc.hku.hken_US
dc.identifier.authorityLeung, SY=rp00359en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid1481645-
dc.identifier.scopuseid_2-s2.0-0026679586en_US
dc.identifier.volume86en_US
dc.identifier.issue6en_US
dc.identifier.spage588en_US
dc.identifier.epage592en_US
dc.identifier.isiWOS:A1992KD88000009-
dc.publisher.placeDenmarken_US

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