The Rational Clinical Examination
David L. Simel, Drummond Rennie
Parkinsonism
Goutham Rao, Richard Bedlack
Make the Diagnosis: Parkinsonism
Topics Discussed:
criterion standard comparisons (diagnostic tests), glabella reflex, make the diagnosis, parkinson disease, parkinsonian disorders, prior probability
Excerpt:
"Parkinson disease remains a clinical diagnosis. No accurate laboratory
or radiologic test is currently available. An acute challenge with levodopa,
followed by monitoring for improvement of symptoms, is not useful
diagnostically. Parkinson disease affects 1% of people older than 65
years and 2% of those older than 85 years.2 The
prevalence among older patients presenting with general neurologic
complaints is almost certainly much higher, but precise figures
are unavailable. ..."
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