Vascular parkinsonism: what makes it different?

  title={Vascular parkinsonism: what makes it different?},
  author={Deepak Gupta and Abraham C Kuruvilla},
  journal={Postgraduate Medical Journal},
  pages={829 - 836}
  • D. Gupta, A. Kuruvilla
  • Published 25 November 2011
  • Medicine, Psychology, Biology
  • Postgraduate Medical Journal
Vascular parkinsonism (VP) accounts for 2.5–5% of all cases of parkinsonism in various population based and clinical cohort studies. VP develops as a result of ischaemic cerebrovascular disease, so aetiologically it is classified as secondary parkinsonism. It has been variably referred to in the literature as arteriosclerotic parkinsonism, vascular pseudo-parkinsonism, and lower body parkinsonism. The most important consideration while making a diagnosis of VP should be to differentiate VP from… 
Vascular parkinsonism—characteristics, pathogenesis and treatment
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Current understanding of the clinical characteristics of VP, as well as knowledge gained from neuroimaging and nuclear imaging of the pathological features of VP are summarized, and consideration is given to whether the overlap between VP and Binswanger disease means that these two disorders should be considered as part of the same disease entity.
Vascular Parkinsonism and cognitive impairment: literature review, Brazilian studies and case vignettes
Physicians are provided with an insight on the practical issues of VP, a disease potentially confounded with vascular dementia, idiopathic Parkinson's disease, dementia with Lewy bodies and other secondary causes of Parkinsonism.
Parkinsonism and cerebrovascular disease
Efficacy of dopamine agonist treatment in delayed-onset parkinsonism due to midbrain hemorrhage.
Vascular parkinsonism: a case series of 17 patients.
This case series provides a profile of VP with predominant lower-limb involvement, freezing of gait and falls, pyramidal signs, executive dysfunction, concomitant vascular dementia, and poor levodopa response.
Jaw tremor: a manifestation of vascular parkinsonism? - a case report
This case describes atypical clinical features which could be associated with VP including jaw tremor and stresses the importance of initiating a trial of levodopa as certain patients may respond well to medication.
Clinicoradiological comparison between vascular parkinsonism and Parkinson’s disease
VP can be clinically distinguished from PD based on sudden onset of parkinsonism at an older age, characterised by lower body predominance, urinary incontinence, pyramidal signs, postural instability with freezing of gait and falls, and dementia.
Subclinical vascular disease and the risk of parkinsonism: The Rotterdam Study.
Clinical Application of Brain MRI in the Diagnostic Work-up of Parkinsonism
The main purpose of brain MRI is to assess cerebrovascular damage, and to exclude other possible – and sometimes treatable – causes of parkinsonism, such as normal pressure hydrocephalus.
The Relationship of Clinical Treatment to Quality of Life in a Patient with Vascular Parkinsonism : A Case Report from a Pharmacist ’ s Perspective
Physical activity may be useful for establishing a higher QoL in VP, and should have been started at the early-stage treatment, and further study is warranted on the use of multiple drugs in the elderly with VP.


Clinical correlates of vascular parkinsonism.
Compared with PD, patients with parkinsonism associated with vascular disease are more likely to present with gait difficulty and postural instability rather than tremor, have a history of stroke and risk factors for stroke, and fail to respond to levodopa therapy.
Vascular parkinsonism: a distinct, heterogeneous clinical entity
The differences in the clinical features support the concept that VP is a distinct clinical entity with heterogeneous clinical, MRI, and possibly pathophysiological features.
Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis
New clinical criteria for a diagnosis of VP are proposed based on the clinicopathological findings of this study, and the clinical features at presentation varied according to the speed of onset and the underlying vascular pathological state.
Different clinical and evolutional patterns in late idiopathic and vascular parkinsonism
Clinical history, symptoms, signs, response to therapy, and brain imaging help to differentiate PD and VP as two clinical entities with different clinical, prognostic and therapeutic implications, even if the coexistence of PD and a cerebral vascular disease in elderly patients is not infrequent and can make the diagnosis difficult.
Neurological signs and frontal white matter lesions in vascular parkinsonism. A clinicopathologic study.
The core signs and symptoms of autopsy-proved VP differ from those of typical Parkinson's disease, and most VP patients had diffuse cerebral white matter lesions as well as basal ganglia lesions.
Neurological Signs and Frontal White Matter Lesions in Vascular Parkinsonism
VP was characterized clinically by a short-stepped or frozen gait, lead-pipe rigidity, absence of resting tremor, and negative response to levodopa, and half or more of VP patients demonstrated pyramidal tract signs and ps...
Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study
Prevalence and clinical characteristics of NMS in patients with atypical and secondary parkinsonism and the prevalence of skin and respiratory disorders was rather low in all forms, ranging between 10 and 30%.
Vascular pseudoparkinsonism
Investigation of parkinsonian patients seen in the Movement Disorders Clinic for a possible vascular etiology found three anatomical patterns with different prognosis were identified, including bilateral frontal lobe watershed infarcts and the absence of brain stem Lewy bodies.
Atypical Parkinsonian Disorders: Clinical and Research Aspects
The best definition of atypical parkinsonism is still an anatomoclinical one because even a postmortem exam does not always yield an accurate histopathologic diagnosis and is of limited value to the patients and their caregivers.