Objective:

Using precise diagnostic criteria, the single-center observational study aims to evaluate the clinical profiles of non-IPD parkinsonism, specifically identifying crucial clinical clues for discriminating between neurodegenerative and secondary parkinsonism.

Background: The clinical presentation of atypical and secondary causes of parkinsonism frequently manifests with overlapping features, posing challenges in diagnosis and differentiation.

Method: The study rigorously evaluates individuals Presenting with parkinsonism along with red flag signs, following MDS criteria. Employing a holistic approach, it combines thorough history-taking, neurological exams, cognitive assessments (MMSE), and MRI, with additional autonomic testing when clinically indicated, enhancing diagnostic precision.

Results: Among 84 patients, 50 (59.5%) had atypical parkinsonism, 23 (27.4%) had secondary parkinsonism, and 11 (13.1%) remained undiagnosed. Atypical parkinsonism included MSA (34%), PSP (28%), and DLB (12%), while secondary parkinsonism comprised NPH (35%), drug-induced (22%), vascular (13%), and others. Comparing atypical and secondary parkinsonism revealed significant differences in tremor (40% vs. 11.11%), gait instability (31% vs. 62%), levodopa responsiveness (30% vs. 5%), and pyramidal signs (17% vs. 38%). Oculomotor abnormalities were more prevalent in atypical parkinsonism (66% vs. 39%).

Conclusion: Significant distinctions were observed between atypical and secondary parkinsonism in tremors, oculomotor abnormalities, levodopa responsiveness, gait instability, and pyramidal signs. Future research should focus on the creation of a non-neurologist-friendly scoring system.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/decoding-non-ipd-parkinsonism-a-comparative-analysis-of-atypical-and-secondary-parkinsonism/