帕金森病的诊断方法。
Approach to diagnosis of Parkinson disease.
作者信息
Frank Christopher, Pari Giovanna, Rossiter John P
机构信息
St Mary's of the Lake Hospital, Kingston, ON.
出版信息
Can Fam Physician. 2006 Jul;52(7):862-8.
OBJECTIVE
To review the clinical features of Parkinson disease (PD) and other causes of motor parkinsonism with an emphasis on diagnosis in elderly patients. SOURCES OF INFORMATION MEDLINE: and Google Scholar were searched for original research articles describing clinical diagnosis of parkinsonism. Consensus statements and articles summarizing diagnostic criteria for parkinsonian syndromes were also reviewed. Most evidence was levels II or III.
MAIN MESSAGE
Diagnosis of PD is made clinically and can be challenging. In older patients, PD can present with general functional decline and nonspecific symptoms. Clinical criteria for diagnosing PD and the TRAP mnemonic can be helpful. A 2-week trial of levodopa-carbidopa treatment can be considered. Specific signs and a minimal response to levodopa treatment suggest other causes of parkinsonism. Clinical features of other causes of parkinsonism are reviewed in the article.
CONCLUSION
Parkinsonism and PD are common in older patients. Family physicians should consider parkinsonism in the differential diagnosis of patients who have falls and exhibit general functional decline.
目的
回顾帕金森病（PD）及其他导致运动性帕金森综合征的病因的临床特征，重点关注老年患者的诊断。信息来源：检索了MEDLINE和谷歌学术，以查找描述帕金森综合征临床诊断的原始研究文章。还查阅了关于帕金森综合征诊断标准的共识声明和综述文章。大多数证据为II级或III级。
主要信息
PD的诊断基于临床，可能具有挑战性。在老年患者中，PD可能表现为整体功能衰退和非特异性症状。诊断PD的临床标准和TRAP记忆法可能会有所帮助。可考虑进行为期2周的左旋多巴-卡比多巴治疗试验。特定体征以及对左旋多巴治疗反应极小提示帕金森综合征有其他病因。本文回顾了帕金森综合征其他病因的临床特征。
结论
帕金森综合征和PD在老年患者中很常见。家庭医生在对跌倒且表现出整体功能衰退的患者进行鉴别诊断时应考虑帕金森综合征。
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