Exam Cram

• Parkinson plus Syndrome

• Presentation: Parkinsonism + autonomic neuropathy, classically postural instability

• Poor response to levodopa

Outline

Background 

Assessment

History:

• Reduced mobility, falls, dizziness

• Low mood

• Autonomic features: difficulty voiding urine & postural hypotension

Examination:

• Ataxia

• Rigidity

• Tremor

Investigations

• Large postural drop > 20/10mmhg

Diagnosis

Diagnostic criteria: 

• clinical diagnosis- parkinsonism with autonomic neuropathy, poorly responsive to levo-dopa

Differentials

• Parkinson's disease: Good response to levodopa

• Progressive Supranuclear Palsy:     Double vision in vertical plane

• Lewy Body Dementia:       Visual hallucinations, memory loss more prominant feature

• Normal pressure hydrocephalus:         Urinary incontinence

Management

Deeper Dive

References

Page written in 2024. 

Produced off FOAM basis: free, open access, medical education. This is not clinical advice, education for multiple choice questions only! 

Produced to the best of the author's ability. Any issues please contact contact: MunroMedics@gmail.com