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Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia, rigidity, and postural instability.^[1]^[2] Parkinsonism shares symptoms found in Parkinson's disease, from which it is named; but parkinsonism is a symptom complex, and differs from Parkinson disease which is a progressive neurodegenerative illness. The underlying causes of parkinsonism are numerous, and diagnosis can be complex.^[3]^[4] The neurodegenerative condition Parkinson's disease (PD) is the most common cause of parkinsonism. However, a wide range of other etiologies may lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of neurological conditions other than Parkinson's.^[5]

About 7% of people with parkinsonism have developed their symptoms following treatment with particular medications. Side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), piperazines (such as ziprasidone), and, rarely, antidepressants. The incidence of drug-induced parkinsonism increases with age. Drug induced parkinsonism tends to remain at its presenting level, not progress like Parkinson's disease.^[6]

Differential diagnoses

Differentiating some kinds of atypical Parkinson. Northwest Parkinson Foundation

Before Parkinson's disease is diagnosed the differential diagnoses include:

AIDS can sometimes lead to the symptoms of secondary parkinsonism, due to commonly causing dopaminergic dysfunction. Indeed, parkinsonism can be a presenting feature of HIV infection.^[7]
Corticobasal degeneration^[1]
Creutzfeldt-Jakob disease^[8]
Dementia pugilistica or "boxer's dementia" is a condition that occurs in boxers due to chronic brain trauma
Diffuse Lewy body disease^[1]
Drug-induced parkinsonism ("pseudoparkinsonism") due to drugs such as antipsychotics, metoclopramide, MPTP^[1]^[9]
Encephalitis lethargica^[1]
Essential tremor, an illness which has some diagnostic overlap with Parkinson's disease.^[10]
Multiple system atrophy^[11]
Pantothenate kinase-associated neurodegeneration, also known as Neurodegeneration with brain iron accumulation (NBIA) or Hallervorden-Spatz syndrome^[12]^[13]
Parkinson plus syndrome
Progressive supranuclear palsy^[1]
Toxicity due to substances such as carbon monoxide,^[14] carbon disulfide,^[14] manganese,^[14] paraquat,^[15] mercury,^[16] hexane, rotenone, Annonaceae, and toluene^[17] (inhalant abuse: "huffing")^[18]
Vascular parkinsonism, associated with underlying cerebrovascular disease^[19]^[20]
Wilson's disease is a genetic disorder in which there is an abnormal accumulation of copper. The excess copper can lead to the formation of a copper-dopamine complex, which leads to the oxidation of dopamine to aminochrome.^[21] The most common manifestations include bradykinesia, cogwheel rigidity^[22] and a lack of balance.^[23]
Paraneoplastic syndrome: neurological symptoms caused by antibodies associated with cancers
Genetic
- Rapid onset dystonia parkinsonism (DYT12)
- Parkin mutation
- X-linked dystonia parkinsonism (DYT3)
- Autosomal recessive juvenile parkinsonism (ARJP)

References

^ ^a ^b ^c ^d ^e ^f Aminoff MJ, Greenberg DA, Simon RP (2005). Clinical Neurology (6th ed.). Lange: McGraw-Hill Medical. pp. 241–5. ISBN 0-07-142360-5.
^ Bradley J. Robottom; William J. Weiner; Lisa M. Shulman. "42". International Neurology: A Clinical Approach. Blackwell Publishing Ltd. pp. 152–158. ISBN 978-1-405-15738-4.
^ Rao G, Fisch L, Srinivasan S, et al. Does this patient have Parkinson disease? JAMA. 2003;289(3):347-353. PMID 12525236
^ Tuite PJ, Krawczewski K (2007). "Parkinsonism: a review-of-systems approach to diagnosis". Seminars in neurology. 27 (2): 113–22. doi:10.1055/s-2007-971174. PMID 17390256.
^ Christine CW, Aminoff MJ (2004). "Clinical differentiation of parkinsonian syndromes: prognostic and therapeutic relevance". Am. J. Med. 117 (6): 412–9. doi:10.1016/j.amjmed.2004.03.032. PMID 15380498.
^ http://www.parkinsons.org.uk/PDF/FS38_druginducedparkinsonism.pdf
^ Tse W, Cersosimo MG, Gracies JM, et al. (2004). "Movement disorders and AIDS: a review". Parkinsonism Relat. Disord. 10 (6): 323–34. doi:10.1016/j.parkreldis.2004.03.001. PMID 15261874.
^ Maltête D, Guyant-Maréchal L, Mihout B, Hannequin D (2006). "Movement disorders and Creutzfeldt-Jakob disease: a review". Parkinsonism Relat. Disord. 12 (2): 65–71. doi:10.1016/j.parkreldis.2005.10.004. PMID 16364674.
^ Watanabe Y, Himeda T, Araki T (2005). "Mechanisms of MPTP toxicity and their implications for therapy of Parkinson's disease" (PDF). Med. Sci. Monit. 11 (1): RA17–23. PMID 15614202.
^ http://www.news-medical.net/news/20090902/LINGO1-variant-responsible-for-essential-tremors-and-Parkinsons-disease.aspx
^ Wenning GK, Geser F (2003). "Multiple system atrophy". Rev. Neurol. (Paris). 159 (5 Pt 2): 3S31–8. PMID 12773886.
^ Uc EY, Rodnitzky RL (2003). "Childhood dystonia". Seminars in pediatric neurology. 10 (1): 52–61. doi:10.1016/S1071-9091(02)00010-4. PMID 12785748.
^ Online 'Mendelian Inheritance in Man' (OMIM) NEURODEGENERATION WITH BRAIN IRON ACCUMULATION 1; NBIA1 -234200
^ ^a ^b ^c DeLong MR, Juncos JL (2004). Parkinson's Disease and Other Movement Disorders. In: Harrison's Principles of Internal Medicine (16th ed.). McGraw-Hill Professional. p. 2414. ISBN 0-07-140235-7.
^ Dinis-Oliveira RJ, Remião F, Carmo H, et al. (2006). "Paraquat exposure as an etiological factor of Parkinson's disease". Neurotoxicology. 27 (6): 1110–22. doi:10.1016/j.neuro.2006.05.012. PMID 16815551.
^ Tremor/InvoluntaryMovements: Excerpt from Field Guide to Bedside Diagnosis
^ Weiss J. Chapter 151. Toluene and Xylene. In: Olson KR, ed. Poisoning & Drug Overdose. 6th ed. New York: McGraw-Hill; 2012. http://www.accessmedicine.com/content.aspx?aID=55982958. Accessed April 21, 2013.
^ http://onlinelibrary.wiley.com/doi/10.1002/ana.410350516/abstract
^ Thanvi B, Lo N, Robinson T (2005). "Vascular Parkinsonism--an important cause of parkinsonism in older people" (PDF). Age and ageing. 34 (2): 114–9. doi:10.1093/ageing/afi025. PMID 15713855.
^ http://parkinsonsdiseasefoundation.blogspot.com/2012/08/vascular-parkinsonism.html
^ Członkowska A, Tarnacka B, Möller JC, et al. (2007). "Unified Wilson's Disease Rating Scale — a proposal for the neurological scoring of Wilson's disease patients". Neurol. Neurochir. Pol. 41 (1): 1–12. PMID 17330175.
^ Ropper AH, Samuels MA. Chapter 4. Abnormalities of Movement and Posture Caused by Disease of the Basal Ganglia. In: Ropper AH, Samuels MA, eds. Adams and Victor's Principles of Neurology. 9th ed. New York: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3630437. Accessed April 21, 2013.
^ Lorincz MT (January 2010). "Neurologic Wilson's disease". Ann. N. Y. Acad. Sci. 1184: 173–87. doi:10.1111/j.1749-6632.2009.05109.x. PMID 20146697.

External links

GeneReviews/NIH/NCBI/UW entry on Perry syndrome
GeneReviews/NCBI/NIH/UW entry on X-Linked Dystonia-Parkinsonism

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. パーキンソン病の診断 diagnosis of parkinson disease
2. 進行性核上性麻痺（PSP） progressive supranuclear palsy psp
3. 多系統萎縮症：臨床的特徴および診断 multiple system atrophy clinical features and diagnosis
4. 高齢者における神経性歩行障害 neurologic gait disorders of elderly patients
5. 大脳皮質基底核変性症 corticobasal degeneration

English Journal

Screening for C9orf72 repeat expansions in parkinsonian syndromes.

Yeh TH, Lai SC, Weng YH, Kuo HC, Wu-Chou YH, Huang CL, Chen RS, Chang HC, Traynor B, Lu CS.SourceSection of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan, Taiwan.
Neurobiology of aging.Neurobiol Aging.2013 Apr;34(4):1311.e3-4. doi: 10.1016/j.neurobiolaging.2012.09.002. Epub 2012 Oct 11.
Parkinsonism might precede, coincide, or follow the behavioral or language-predominant cognitive impairments characteristic of frontotemporal dementia (FTD). In this study, we analyze the hexanucleotide repeat expansions within C9orf72 gene in various parkinsonian syndromes because it is a recently
PMID 23063644

3-[(2,4-dimethoxy)benzylidene]-anabaseine dihydrochloride protects against 6-hydroxydopamine-induced parkinsonian neurodegeneration through α7 nicotinic acetylcholine receptor stimulation in rats.

Suzuki S, Kawamata J, Matsushita T, Matsumura A, Hisahara S, Takata K, Kitamura Y, Kem W, Shimohama S.SourceDepartment of Neurology, School of Medicine, Sapporo Medical University, Sapporo, Japan.
Journal of neuroscience research.J Neurosci Res.2013 Mar;91(3):462-71. doi: 10.1002/jnr.23160. Epub 2012 Dec 14.
To explore a novel therapy against Parkinson's disease through enhancement of α7 nicotinic acetylcholine receptor (nAChR), we evaluated the neuroprotective effects of 3-[(2,4-dimethoxy)benzylidene]-anabaseine dihydrochloride (DMXBA; GTS-21), a functionally selective α7 nAChR agonist, in a rat 6-hy
PMID 23239187

Neuroprotective and reparative effects of carotid body grafts in a chronic MPTP model of Parkinson's disease.

Muñoz-Manchado AB, Villadiego J, Suárez-Luna N, Bermejo-Navas A, Garrido-Gil P, Labandeira-García JL, Echevarría M, López-Barneo J, Toledo-Aral JJ.SourceInstituto de Biomedicina de Sevilla-IBiS, HUVR/Universidad de Sevilla/CSIC, Seville, Spain; Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain.
Neurobiology of aging.Neurobiol Aging.2013 Mar;34(3):902-15. doi: 10.1016/j.neurobiolaging.2012.06.001. Epub 2012 Jun 27.
Intrastriatal transplantation of dopaminergic carotid body (CB) cells ameliorates parkinsonism in animal models and, with less efficacy, in Parkinson's disease patients. CB-based cell therapy was initially proposed because of its high dopamine content. However, later studies suggested that its benef
PMID 22743091

Japanese Journal

Transverse-Sigmoid Sinus Dural Arteriovenous Fistula Presenting With Parkinsonism:—Case Report—

HATTORI Tomoji,TAKEUCHI Taku,KABEYA Ryusuke,ANDO Kazuhiko,TOSAKI Fujio
Neurologia medico-chirurgica 53(4), 224-227, 2013
Dural arteriovenous fistula (DAVF) is rarely associated with parkinsonism. A 52-year-old woman presented with a rare case of DAVF manifesting as parkinsonism and subsequently akinetic mutism. She show …
NAID 130003364227

Behavioral Performance at Early (4 Weeks) and Later (6 Months) Stages in Rats With Unilateral Medial Forebrain Bundle and Striatal 6-Hydroxydopamine Lesions

SUN Wei,SUGIYAMA Kenji,ASAKAWA Tetsuya,ITO-YAMASHITA Tae,NAMBA Hiroki
Neurologia medico-chirurgica 53(1), 7-11, 2013
… Our previous studies showed differences in striatal D2 receptor functional activity between two different rat parkinsonian models, with lesions induced by 6-hydroxydopamine injection in the striatum and in the medial forebrain bundle (MFB) at both early (4 weeks) and later (6 months) stages after lesioning. … More behavioral tests of different mechanisms with simultaneous molecular studies are needed for evaluation of parkinsonian animal models and the efficacy of treatments. …
NAID 130003364188

Dopamine release via the vacuolar ATPase V0 sector c-subunit, confirmed in N18 neuroblastoma cells, results in behavioral recovery in hemiparkinsonian mice

Duo Jin,Muramatsu Shin-ichi,Shimizu Nobuaki,Yokoyama Shigeru,Hirai Hirokazu,Yamada Kiyofumi,Liu Hong-Xiang,Higashida Chiharu,Hashii Minako,Higashida Akihiko,Asano Masahide,Ohkuma Shoji,Higashida Haruhiro
Neurochemistry International 61(6), 907-912, 2012-11-00
… These results indicated that ATP6V0C mediates DA release from nerve terminals in the striatum of DA neurons of normal mice and from gene-transferred striatal cells of parkinsonian mice. …
NAID 120004966609

Related Pictures

★リンクテーブル★

リンク元	「パーキンソン病様」
拡張検索	「parkinsonian-like」「parkinsonian plus syndrome」「parkinsonian-plus syndrome」

「パーキンソン病様」

Parkinsonism
Classification and external resources
Specialty	neurology
ICD-10	G20-G21
ICD-9-CM	332
DiseasesDB	24212
MedlinePlus	000759
MeSH	D020734
	[edit on Wikidata]