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vascular parkinsonism
Etiology:
- cerebral small-vessel disease [3]
- lacunar infarcts
Clinical manifestations:
1) lower-body parkinsonism
a) gait disturbance as the prominent feature
b) often minimal upper body involvement
2) additional neurologic deficits
a) pyramidal tract signs
b) pseudobulbar palsy
Radiology:
- association with MRI white-matter hyperintensities
Management:
- generally poor response to levodopa/carbidopa (Sinemet)
General
parkinsonism
arterial disease
References
- Diseases of the Nervous System. Clinical Neurobiology.
Asbury, McKhann, McDonald eds. Saunders 1992 2nd ed.
- Lang AE & Lazano AM
Parkinson's disease. First of two parts.
NEJM 339(15):1044-53 1998
PMID: 9761807
- Jacob MA et al.
Cerebral small vessel disease progression increases risk of incident
parkinsonism.
Ann Neurol 2023 Feb 10; [e-pub].
PMID: 36762437
https://onlinelibrary.wiley.com/doi/10.1002/ana.26615