Objective: Here, our aim was to identify the characteristics of atypical clinical presentations of atypical parkinsonism syndromes in our cohort and our secondary aim was to analyze the presence of secondary causes if present.

Background: In atypical parkinsonism syndromes (APS), presentations other than current diagnostic criteria are considered atypical findings or atypical clinical presentations, which were described previously in literature and were suggested to indicate some specific syndromes in some instances and clinical heterogeneity in others.

Method: The medical records of all patients who were admitted with parkinsonism between January 2011 and January 2022 were retrospectively analyzed and patients with APS were determined based on current clinical criteria. We evaluated the neurological, psychiatric, radiological and electrophysiological findings. Typical and atypical features were classified according to the current clinical criteria and previous reports.

Results: We determined 51 patients with APS; 46 patients were included whereas five patients were excluded due to insufficient follow-up. There were patients with multiple system atrophy (n=19), diffuse Lewy body dementia (n=10), frontotemporal dementia (n=10), corticobasal syndrome (n=3), progressive supranuclear palsy (n=4). The prevalence of atypical clinical presentations was similar among different types of APS (p=0.847). In each degenerative condition, there were certain atypical clinical presentations.

Conclusion: There were atypical clinical presentations such as abnormal saccades, myoclonus and ataxia in certain degenerative syndromes. However, family history, onset at an earlier age, and certain neurological findings suggest genetic syndromes.

References: Hirschbichler ST, Erro R, Ganos C, Stamelou M, Batla A, Balint B, Bhatia KP. “Atypical” atypical parkinsonism: Critical appraisal of a cohort. Parkinsonism Relat Disord. 2017 Apr;37:36-42. doi: 10.1016/j.parkreldis.2016.12.006. Epub 2016 Dec 14. PMID: 28236526.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/atypical-parkinsonism-syndromes-clinical-presentations/