3 minute read


Clinical Syndromes, Clinical Features Of Parkinsonism, Neuroanatomical Considerations, TreatmentPrognosis

Parkinsonism is a term that describes a group of disorders in which patients present with varying combinations of tremor, muscle rigidity, slowed movements (bradykinesia), and postural disturbances, including falls. In addition to these signs (not all of which need to be present), patients with parkinsonism also exhibit other neurological symptoms. Parkinsonism needs to be distinguished from idiopathic Parkinson's disease, in which the cardinal diagnostic features of tremor, rigidity, bradykinesia, and postural disturbance are present. To make a diagnosis of Parkinson's disease, each of these symptoms must be present and responsive to levodopa, a medication that is converted to dopamine, which is a natural substance depleted in Parkinson's disease. In addition, from a neuropathological point of view, patients with idiopathic Parkinson's disease have dopaminergic cell degeneration in substantia nigra, an area found in the deep part of the brain, and these cells contain characteristic debris within the nuclei of the cells, called Lewy bodies. Patients with parkinsonism, in Marie Kenny, ninety, of Falls Church, Virginia, who has Parkinson's disease, carries the Olympic torch through her hometown on December 21, 2001. Kenny was nominated to carry the torch for the 2002 Winter Games by her daughter, who wanted to honor her mother for raising a family as a single mother in the 1960s. (AP photo by Linda Spillers.) general, do not have these neuropathological findings in the substantia nigra to the same extent and, clinically, they are poorly responsive to levodopa.

Parkinsonism, either alone, (as in Parkinson's disease) or in association with other neurological illnesses, appears to reduce life expectancy in older adults. How this occurs is not clear, nor is it clear what role treatment plays. These and other issues suggest that further research is needed to come to grips with the challenge of parkinsonism in an aging society.



COLCHER A., and SIMUNI, T. "Other Parkinson Syndromes." In Neurologic Clinics: Movement Disorders, vol. 19. Edited by H. I. Hurtig and M. B. Stern. Philadelphia: W. B. Saunders, 2001. Pages 629–649. CUMMINGS, J. L. "Intellectual Impairment in Parkinson's Disease: Clinical, Pathologic, and Biochemical Correlates." Journal of Geriatric Psychiatry and Neurology 1 (1988): 24–36.

HUGHES, A. J.; DANIEL, S. E.; and LEES, A. J. "The Clinical Features of Parkinson's Disease in 100 Historically Proven Cases." Advanced Neurology 60 (1993): 595–599.

LOUIS, E. D., and FAHN, S. "Pathologically Diagnosed Diffuse Lewy Body Disease and Parkinson's Disease: Do the Parkinsonian Features Differ?" Advanced Neurology 69 (1996): 311–314.

MARK, M. H. "Lumping and Splitting the Parkinson Plus Syndromes: Dementia with Lewy Bodies, Multiple System Atrophy, Progressive Supranuclear Palsy, and Cortical-Basal Ganglionic Degeneration." Neurologic Clinics: Movement Disorders, vol. 19. Edited by H. I. Hurtig and M. B. Storm. Philadelphia: W. B. Saunders, 2001. Pages 607–627.

MITCHELL, S., and ROCKWOOD, K. "The Association between Parkinsonism, Alzheimer's Disease, and Mortality: A Comprehensive Approach." Journal of the American Geriatric Society 48 (2000): 422–425.

MORTIMER, J. A.; CHRISTENSEN, K. J.; and WEBSTER, D. D. "Parkinsonian Dementia." In Handbook of Clinical Neurology, vol. 46. Edited by P. J. Vinken, G. W. Bruyn, and H. L. Klawans. Amsterdam: Elsevier; 1985. Pages 371–384.

RAJPUT, A. H. "Prevalence of Dementia in Parkinson's Disease." In Parkinson's Disease: Neurobehavioral Aspects. Edited by S. J. Huber and J. L. Cummings. New York: Oxford University Press, 1992. Pages 119–131.

WENNING, G. K.; BEN-SHLOMO, Y.; MAGALHAES, M.; DANIEL, S. E.; and QUINN, N. P. "Clinicopathological Study of 35 Cases of Multiple System Atrophy." Journal of Neurology, Neurosurgery, and Psychiatry 58 (1995): 160–166.

Additional topics

Medicine EncyclopediaAging Healthy - Part 3