Objective: To analyze the clinical, neurological, and anamnestic characteristics of patients with vascular parkinsonism.

Background: Vascular parkinsonism (VP)  remains a significant diagnostic challenge due to its clinical similarity to Parkinson’s disease and the lack of well-defined diagnostic criteria.

Method: A total of 48 patients with vascular parkinsonism were examined. Clinical and neurological assessment was performed using the Unified Parkinson’s Disease Rating Scale (UPDRS), the Hoehn and Yahr scale (Lindvall modification), the Schwab and England Activities of Daily Living Scale, the Extrapyramidal Symptom Rating Scale (ESRS), and the Parkinson’s Disease Questionnaire (PDQ-39). The clinical form of the disease, stage, rate of progression, age at onset, provoking factors, and neuroimaging findings (MRI) were evaluated.

Results: The mean age of patients was 69.98±9.57 years, and the mean age at onset was 65.14±12.4 years. The disease most frequently manifested with stiffness and slowness of movements (77.1%), predominantly affecting the lower extremities (79.7%), with symmetrical onset in 77.1% of patients. Resting tremor was observed significantly less frequently (16.7%). A rapid progression rate was noted in 54.2% of patients, and the akinetic-rigid form was the most common (47.9%). According to the Hoehn and Yahr scale, stages II and III predominated (43.75% and 39.5%, respectively). The most common clinical manifestations included postural instability (83.3%), pseudobulbar syndrome (77.1%), asymmetry of deep tendon reflexes (68.75%), and cerebellar disturbances (35.4%). The most frequent provoking factors were psychoemotional stress (37.5%) and previous stroke (23%).

Conclusion: VP is characterized by late onset, symmetrical involvement with predominant impairment of the lower extremities, rapid disease progression, early development of postural instability, and frequent association with pyramidal, cerebellar, and pseudobulbar symptoms.

References: VP is characterized by late onset, symmetrical involvement with predominant impairment of the lower extremities, rapid disease progression, early development of postural instability, and frequent association with pyramidal, cerebellar, and pseudobulbar symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-features-of-vascular-parkinsonism/