Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece; Aiginiteion Hospital, First Department of Neurology, University of Athens, Greece; Clinic for Neurology, Philipps University, Marburg, Germany.
Int Rev Neurobiol. 2019;149:1-34. doi: 10.1016/bs.irn.2019.10.001. Epub 2019 Nov 21.
Parkinsonism is a clinical syndrome defined by bradykinesia plus rigidity or tremor. Though most commonly encountered in the setting of idiopathic Parkinson's disease, a number of neurodegenerative, structural, metabolic and toxic neurological disorders can result in parkinsonism. Accurately diagnosing the underlying cause of parkinsonism is of both therapeutic and prognostic relevance, especially as we enter the era of disease-modifying treatment trials for neurodegenerative disorders. Being aware of the wide array of potential causes of parkinsonism is of paramount importance for clinicians. In this chapter, we present a pragmatic clinical approach to patients with parkinsonism, specifically focusing on 'red flags', which should alert one to consider diagnoses other than idiopathic Parkinson's disease.
帕金森病是一种以运动迟缓伴发或不伴发僵硬、震颤为特征的临床综合征。虽然帕金森病最为常见，但许多神经退行性疾病、结构性疾病、代谢性疾病和中毒性神经疾病也可导致帕金森综合征。准确诊断帕金森综合征的潜在病因具有治疗和预后的双重意义，尤其是在我们进入神经退行性疾病的疾病修饰治疗试验时代后。临床医生对帕金森病可能存在的多种病因有充分的认识至关重要。在本章中，我们针对帕金森病患者提出了一种实用的临床处理方法，特别是对“警示征象”的阐述，这些征象可以提醒医生考虑除特发性帕金森病以外的其他诊断。
