RT Journal Article
SR Electronic
T1 Improving the diagnostic accuracy in parkinsonism: a three-pronged approach
JF Practical Neurology
JO Pract Neurol
FD BMJ Publishing Group Ltd
SP 77
OP 87
DO 10.1136/practneurol-2011-000132
VO 12
IS 2
A1 Marjolein B Aerts
A1 Rianne A J Esselink
A1 Bart Post
A1 Bart P C van de Warrenburg
A1 Bastiaan R Bloem
YR 2012
UL http://pn.bmj.com/content/12/2/77.abstract
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.