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parkinson plus syndrome
Differentiated from Parkinson's disease by the presence of additional signs & symptoms.
Clinical manifestations:
- often more rapidly progressive than Parkinson's disease
Laboratory:
- L-dopa decarboxylase in CSF [3]
* also see Parkinson's disease
Differential diagnosis:
Distinguishing features of Parkinson's disease (PD), progressive supranuclear palsy (PSP) & Shy-Drager syndrome
sign/symptom PD PSP Shy-Drager
bradykinesia 3+ 3+ 3+
rigidity 3+ 3+ 3+
tremor 3+ 1+ 1+
autonomic dysfunction 2+ 1+ 4+
pyramidal signs 0 1+ 0
cerebellar signs 0 1+ 2+
supranuclear gaze palsy 0 3+ 0
response to Sinemet + - -
* PSP: progressive supranuclear palsy
* PD: Parkinson's disease
Management:
- generally unresponsive to Sinemet [2]
- prognosis
- rapid progression
- death within 8-12 years [2]
Interactions
disease interactions
Specific
amyotrophic lateral sclerosis-parkinsonism-dementia complex of Guam
cortical-basal ganglionic degeneration; corticobasal degeneration
disinhibition-dementia-parkinsonism-amyotrophy complex (DDPAC)
frontotemporal dementia with parkinsonism (FTDP-17); multiple system tauopathy with presenile dementia (MSTD)
multiple system atrophy (MSA)
pallidopontonigral degeneration
progressive supranuclear palsy; Steele-Richardson-Olszewski syndrome (PSP)
General
parkinsonism
References
- Saunders Manual of Medical Practice, Rakel (ed),
WB Saunders, Philadelphia, 1996, pg 1051
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18, 19.
American College of Physicians, Philadelphia 1998, 2012, 2015, 2018, 2021
- Pereira JB, Kumar A, Hall S et al
DOPA decarboxylase is an emerging biomarker for Parkinsonian disorders including
preclinical Lewy body disease.
Nat Aging 2023. Sept 18
PMID: 37723208
https://www.nature.com/articles/s43587-023-00478-y