Separating Parkinson's disease from the various causes of atypical parkinsonism (AP) is a common and clinically relevant challenge in clinical practice. Distinguishing between the different causes of AP is even more difficult. Here the authors discuss a systematic, clinically based and three-pronged approach that can assist clinicians in establishing the correct diagnosis in the consulting room. The three consecutive steps include: (1) to verify that the clinical syndrome truly represents parkinsonism (hypokinetic–rigid syndrome); (2) to search systematically for ‘red flags’ (alarm signs that may signal the presence of AP); and (3) to integrate these two steps, as a basis for a narrow differential diagnosis and a guide for further ancillary tests.
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Funding This work is supported by a research grant of the Stichting Internationaal Parkinson Fonds and the Van Alkemade-Keuls Fonds. These non-corporate funding organisations had no role on study design or conduct of the study, data collection, data analysis and interpretation or manuscript preparation
Competing interests None.
Patient consent Obtained.
Provenance and peer review Commissioned. Externally peer reviewed.