PT - JOURNAL ARTICLE AU - Marjolein B Aerts AU - Rianne A J Esselink AU - Bart Post AU - Bart P C van de Warrenburg AU - Bastiaan R Bloem TI - Improving the diagnostic accuracy in parkinsonism: a three-pronged approach AID - 10.1136/practneurol-2011-000132 DP - 2012 Apr 01 TA - Practical Neurology PG - 77--87 VI - 12 IP - 2 4099 - http://pn.bmj.com/content/12/2/77.short 4100 - http://pn.bmj.com/content/12/2/77.full SO - Pract Neurol2012 Apr 01; 12 AB - 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.