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Diagnostic criteria for multiple system atrophy and progressive supranuclear palsy
1Division of Clinical Neurobiology, Department of Neurology, University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. gregorwenning@i-med.ac.at
Revue Neurologique
|September 4, 2010
Summary
Atypical parkinsonian disorders (APD) present with parkinsonism plus other neurological signs, differing from Parkinson's disease. Early diagnosis is challenging, with this review focusing on diagnostic issues in multiple system atrophy and progressive supranuclear palsy.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Atypical parkinsonian disorders (APD) are a heterogeneous group of neurological conditions.
- Key features include parkinsonism accompanied by atypical signs like ataxia, dementia, or autonomic dysfunction.
- Conditions like multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB) are classified as APDs.
Purpose of the Study:
- To review and discuss the diagnostic challenges associated with atypical parkinsonian disorders.
- To focus specifically on the diagnostic difficulties encountered in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP).
Main Methods:
- This is a review article, synthesizing existing literature on APDs.
- The focus is on clinical diagnostic criteria and their limitations.
- Discussion centers on diagnostic issues in MSA and PSP.
Main Results:
- Clinical diagnosis of APDs is often difficult, especially in early stages.
- Established diagnostic criteria have high predictive value initially but low sensitivity (under 30%).
- APD are characterized by rapid progression and poor response to L-Dopa therapy.
Conclusions:
- Accurate early diagnosis of APDs remains a significant clinical challenge.
- Further refinement of diagnostic criteria and methods for MSA and PSP is warranted.
- Distinguishing APDs from idiopathic Parkinson's disease is crucial for appropriate management.
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