Diagnostic pitfalls for parkinsonism and tremor disorders: a clinical approach

ABSTRACT

Differentiation of idiopathic Parkinson's disease from other causes of Parkinsonism, mainly multiple system atrophy, and progressive supranuclar palsy can be difficult and clinicopathological studies suggest that the clinical diagnosis of idiopathic Parkinson's disease is only 76% reliable. Also, clinical differentiation of tremor prominent Parkinsonism from essential tremors may be problematic, especially in early stages of the disease. Since these disorders are obviously different in clinical progress, it is important for the clinician to address the patient's and family's concerns about prognosis from a firm diagnostic footing. In this article the clinical features of the common and important causes of Parkinsonism and tremor disorders are reviewed and a practical approach to these patients is suggested