Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, 1 Wakefield St, London, WC1N 1PJ, UK.
J Neurol Neurosurg Psychiatry. 2012 Oct;83(10):1027-9. doi: 10.1136/jnnp-2012-302828.
To evaluate in detail the clinical features in a large series of pathologically confirmed cases of vascular Parkinsonism (VP).
In the absence of widely accepted diagnostic criteria for VP pathological confirmation of diagnosis is necessary to ensure diagnostic reliability, and has only been reported in a few small series.
DESIGN/METHODS: The archival records of the Queen Square Brain Bank (QSBB) have been used to identify cases of Parkinsonism where cerebrovascular disease was the only pathological finding. Clinical notes were scrutinised and milestones of disease progression were compared with other atypical Parkinsonian syndromes from previous QSBB studies.
Twenty-eight cases were included. Mean age of onset and disease duration were 70.6 (SD± 6.42) and 10.5 (SD± 66.1) years respectively. Bradykinesia was present in all cases, rigidity in 96%, falls in 76%, pyramidal signs in 54%, urinary incontinence in 50% and dementia in 39%.Visual hallucinations in 0%. Two-thirds had an insidious onset and a relentless rather than stepwise progression of disability. When compared with other Parkinsonian syndromes, VP had an older age of onset.
In comparison with other Parkinsonian syndromes the patients were older and had an extremely low frequency of visual hallucinations compared with Parkinson's disease.
详细评估经病理学证实的大量血管性帕金森病（VP）病例的临床特征。
由于缺乏广泛接受的 VP 诊断标准，病理学确诊对于确保诊断的可靠性是必要的，而这仅在少数小系列研究中有所报道。
设计/方法：利用 Queen Square 脑库（QSBB）的档案记录，确定了脑血管病是唯一病理学发现的帕金森病病例。仔细审查了临床记录，并将疾病进展的里程碑与之前 QSBB 研究中其他非典型帕金森综合征进行了比较。
共纳入 28 例患者。发病年龄和病程的平均值分别为 70.6（SD±6.42）岁和 10.5（SD±66.1）年。所有病例均存在运动迟缓，96%存在僵硬，76%存在跌倒，54%存在锥体束征，50%存在尿失禁，39%存在痴呆。0%存在视幻觉。三分之二的患者起病隐匿，残疾进展呈持续而非阶梯式。与其他帕金森综合征相比，VP 的发病年龄更大。
与其他帕金森综合征相比，VP 患者年龄更大，与帕金森病相比，视觉幻觉的发生率极低。
