Parkinson's disease differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Parkinson disease must be differentiated from other diseases that can mimic this disease clinically or radiologically such as: essential tremor, scans without evidence of dopaminergic deficit (SWEDD), dementia with Lewy bodies, multiple system atrophy, corticobasal degeneration, progressive supranuclear palsy, idiopathic and familial basal ganglia calcification, and secondary parkinsonism.

Differential Diagnosis

  • Parkinson disease must be differentiated from other diseases that can mimic this disease clinically or radiologically such as:

Essential tremor

  • Essential tremor is demonstrated by bilateral resting tremor of arms, head, chin and trunk. Tremor of PD is action tremor and it seems to be easy to differentiate it from resting tremor of ET but sometimes we can see resting tremor in PD patient and conversely action tremor in ET patients.[1][2]

Scans without evidence of dopaminergic deficit (SWEDD)

  • Patients with scans without evidence of dopaminergic deficit have upper extremity resting tremor but their disease does not progress to the complete PD and there are no evidence of dopamine depletion in their NS.[3]

Dementia with Lewy bodies

Multiple system atrophy

Corticobasal degeneration

Progressive supranuclear palsy

  • Abnormal gait is the most common presentation of PSP disease. As opposed to idiopathic Parkinson disease, their trunk is extended and arms are abducted. They commonly fall from behind leading to bruises and lacerations.[17] They can also have supranuclear ophthalmoparesis or ophtalmoplegia.[18]

Idiopathic and familial basal ganglia calcification

Secondary parkinsonism

References

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