Parkinson's Plus Info

[John DeGelleke <degellek@xxxxxxxxxxxxxxxx>]

I located an article entitled "Differential Diagnosis of Parkinson's
Disease and the Parkinsonism Plus Syndromes" by Mark Stacy, MD (Dept of
Neurology, U of Missouri, School of Med, Columbia, MO) and Joseph
Jankovic, MD (Dept of Neurology, Parkinson's Disease Center and Movement
Disorders Clinic, Baylor College of Medicine, Houston, TX) that was
published in _Neuological Clinics_, Volume 10, Number 2, May 1992, pages
341-359.

Does anyone know how to import this article for review by our PARKINSN
list members?

They say: "... The second largest group of parkinsonian disorders (12% of
all parkinsonian patiets seen at [Baylor] is classified clinically as
parkinsonism plus syndromes and pathologically as multiple system
degenerations [MSA = Multiple System Atrophy is a common term in many
pieces I've seen]... The lack of improvement with levadopa [sinemet] or
dopamine agonists may be partly explained by fundamental differences in the
density of the postsynaptic dopamine receptors. These receptors are
preserved in Parkinson's disease, but are usually decreased in the other
parkinsonian disorders. This article focuses only on the sporadic
(non-genetic) forms of multiple system degenerations."

Table 3 is particularly good and I'll try to copy it here. It is a matrix
of symptoms vs. syndromes. I will use the following convention:
Y=yes, usually a symptom, N=not usually, B=may or may not be a symptom

Table 3. Differential Diagnosis of Parkinsonism Plus Syndromes


                          PD  PSP  SDS  SND  OPCA  CBGA  ADP  PDCG/ALS
                          --  ---  ---  ---  ----  ----  ---  --------
Bradykinesia              Y    Y    Y    Y    B     Y     B      Y
Rigidity                  Y    Y    Y    Y    Y     Y     B      Y
Gait disturbance          Y    Y    Y    Y    Y     Y     B      Y
Tremor                    Y    N    N    N    B     B     N      Y
Ataxia                    N    N    B    N    Y     N     N      B
Dysautonomia              B    B    Y    B    B     N     N      B
Dementia                  B    Y    B    N    N     B     Y      Y
Dysarthria/dysphagia      B    Y    B    Y    Y     Y     B      Y
Dystonia                  B    B    N    B    N     Y     N      N
Eyelid apraxia            N    Y    N    B    N     B     N      N
Limb apraxia              N    N    N    N    N     Y     B      N
Motor neuron disease      N    N    B    B    N     N     N      Y
Myoclonus                 B    N    N    N    N     Y     B      N
Neuropathy                N    N    B    N    B     N     N      N
Oculomotility disturbance N    Y    B    N    Y     Y     B      N
Orthostatic hypotention   B    B    Y    B    B     N     N      N
Sleep abnormalities       B    B    Y    B    B     N     N      N
Asymmetric findings       Y    N    N    N    N     Y     N      N
Levodopa response         Y    B    B    B    N     N     N      N

where PD = Parkinson'd Disease; PSP = progressive supranuclear palsy; SDS
= Shy-Drager syndrome; SND = striatonigral degeneration; OPCA =
olivopontocerebellar atrophy; CBGD = corticobasal ganglionic degeneration;
ADP = Alzheimer's disease with parkinsonism; PDCG/ALS =
parkinsonism-dementia-amyotrophic lateral sclerosis complex of Guam.

Makes me really appreciate an electronic file when it's available. Thanks
to whomever types all that stuff in.

------------------------------------------------
John DeGelleke (degellek@xxxxxxxxxxxxxxxx)
(johnd@xxxxxxxxxxxxxxx after 1/31/95)
Palm Harbor, FL
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