Objective: We retrospectively analyzed the medical records of all parkinsonism patients admitted to our clinic in 2024, examining neurological, psychiatric, radiological, and demographic characteristics of Parkinson’s disease (PD) and atypical parkinsonism (AP). Our goal was to determine the prevalence and characteristics of AP in our population.

Background: Movement disorders, including PD and AP, pose diagnostic challenges due to overlapping symptoms. Accurate differentiation is crucial for effective management. In 2024, our clinic evaluated 434 patients with movement disorders, including 374 with PD and 9 with AP (6 with progressive supranuclear palsy [PSP], 2 with multiple system atrophy [MSA], and 1 with dementia with Lewy bodies [DLB]). The remaining patients had other movement disorders.

Method: We retrospectively examined demographic data (age, gender), clinical features, and medical history of all parkinsonism patients. Diagnostic classifications followed established criteria, and statistical comparisons identified differences between PD and AP.

Results: We identified 374 patients with Parkinson’s disease (0.86) and 9 patients with atypical types of parkinsonism (0.021) out of 434 patients with movement disorders. Multiple system atrophy (MSA, n = 2), dementia with Lewy bodies (DLB, n = 1), and progressive supranuclear palsy (PSP, n = 6) were the most likely diagnoses. The male-to-female ratio in PD was nearly equal (169:205), whereas AP showed a modest male predominance (8:3). AP patients were older (64.25 vs. 62.6 in PD) and exhibited a faster disease progression, seeking consultation 3–4 years after symptom onset compared to 5–7 years in PD. AP was characterized by autonomic dysfunction and cerebellar ataxia in MSA, early visual hallucinations and cognitive fluctuations in DLB, and postural instability with early falls and vertical gaze palsy in PSP.

Conclusion: AP patients tend to be older, predominantly male, and experience a more rapid disease course with poor response to standard treatments. Early postural instability in PSP, autonomic dysfunction in MSA, and cognitive impairment in DLB highlight the need for early recognition and improved diagnostic precision.

Distribution of Movement Disorders in 2024

Distribution of Atypical Parkinsonism Subtypes

Male-to-Female in PD and AP Patients

MRI of patient with PSP (The hummingbird sign)

References: [1] Atypical Parkinsonian Syndromes | BIDMC of Boston https://www.bidmc.org/conditions-and-treatments/brain-spine-and-nervous-system/atypical-parkinsonian-syndromes
[2] Atypical Parkinsonism: Diagnosis, symptoms, and treatment https://www.medicalnewstoday.com/articles/320551
[3] Atypical Parkinsonism – Symptoms and Causes | Penn Medicine https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/atypical-parkinsonism-syndromes
[4] Atypical Parkinsonian Disorders https://www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/atypical-parkinsonian-disorders
[5] Atypical Parkinsonian Syndromes – Practical Neurology https://practicalneurology.com/articles/2022-sept/atypical-parkinsonian-syndromes
[6] Types of Parkinsonisms https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons/types-parkinsonisms
[7] Atypical Parkinsonism https://www.michaeljfox.org/news/atypical-parkinsonism
[8] Prevalence and Characteristics of Polyneuropathy in Atypical Parkinsonian Syndromes: An Explorative Study https://www.mdpi.com/2076-3425/11/7/879

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