Extrapyramidal syndromes in the elderly: diagnosis and management

Extrapyramidal syndromes are among the most common neurologic conditions afflicting the geriatric patient. Most generally, these disorders can be categorized into those with hypokinetic characteristics (eg, parkinsonism) and those with hyperkinetic features (eg, chorea). Finer diagnostic and etiologic classification can be gained by observing the details of the movement (eg, regular vs. irregular, action vs. resting, proximal vs. distal) and considering accompanying signs, symptoms, and histories (eg, pyramidal signs, ocular abnormalities, cognitive impairments, history of treatment with neuroleptics). Optimal management of these varied syndromes hinges on the accurate identification of their clinical forms and a thorough search for their possible etiologies.