| Atypical Parkinsonian Disorder | Pathophysiology | Core Clinical Features | Distinguishing Features from PD |
|---|---|---|---|
| Dementia with Lewy bodies | Synucleinopathy | • Dementia | |
| • Visual hallucinations | |||
| • Fluctuating cognition | |||
| • Parkinsonism | • Dementia begins before or at the same time as motor symptoms | ||
| Multiple system atrophy | Synucleinopathy; oligodendroglial alpha-synuclein aggregation | • Parkinsonism and/or cerebellar dysfunction | |
| • Autonomic failure | |||
| • Pyramidal signs | • Poor response to levodopa | ||
| • Symmetric motor symptoms | |||
| • Early falls | |||
| • Relatively preserved cognitive function | |||
| • Nocturnal stridor | |||
| Progressive supranuclear palsy | Tauopathy; tau-positive deposits in neurons and glia of basal ganglia, brainstem, cerebellum, and cortex | • Gait disturbance with falls | |
| • Ophthalmoparesis | |||
| • Parkinsonism | • Poor response to levodopa | ||
| • Early falls | |||
| • No tremor | |||
| • Pseudobulbar affect | |||
| Corticobasal degeneration | Tauopathy; tau-positive deposits in neurons and glia of cortex and striatum | • Asymmetric movement disorder (limb rigidity, dystonia, and/or myoclonus) | |
| • Orobuccal or limb apraxia | |||
| • Cortical sensory deficits | |||
| • Alien limb phenomenon | |||
| • Cognitive dysfunction | • Poor response to levodopa | ||
| • Aphasia, apraxia, and cortical sensory loss |
Chou KL. Diagnosis and differential diagnosis of Parkinson disease. In: Hurtig HI, Eichler AF, editors. UpToDate. [Internet]. Waltham (MA): UpToDate Inc. [updated 21 December 2023; cited 11 March 2024]. Available from: Diagnosis and differential diagnosis of Parkinson disease - UpToDate