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2 results

  • Chapter 34 - Vascular Parkinsonism

  • from Section 2: - Hypokinetic Movement Disorders
  • Edited by Erik Ch. Wolters, Universität Zürich, Christian R. Baumann, Universität Zürich
  • Book:
    International Compendium of Movement Disorders
    Published online:
    07 January 2025
    Print publication:
    06 February 2025, pp 414-422

  • Summary

    Vascular parkinsonism (VP) is a clinical entity within the broader context of parkinsonian syndromes and usually manifests with an array of clinical features including a mainly lower body motor parkinsonism with a gait disorder, corticospinal and pseudobulbar signs and symptoms, urinary incontinence, dementia, and pyramidal and cerebellar signs. As the name suggests, etiologically VP may be defined as a secondary parkinsonian syndrome occurring in relation to ischemic cerebrovascular disease. Treatment for VP remains challenging as available data on the efficacy of current treatment options are contentious. VP is generally considered to be poorly responsive to levodopa, the most effective of the current treatment modalities for parkinsonism; however, there is evidence that some patients benefit from therapy with levodopa, especially in case of underlying ischemic or hemorrhagic lesions in the substantia nigra, globus pallidus pars externa, thalamic ventral lateral nuclei, or nigrostriatal pathway, leading to presynaptic dopamine transporter deficiency as measured by single photon emission computed tomography.

  • 15 - Olfaction in Parkinsonian Syndromes

  • from Section III - Assessment and Disorders of Olfaction
  • Edited by Warrick J. Brewer, Mental Health Research Institute of Victoria, Melbourne, David Castle, University of Melbourne, Christos Pantelis
  • Foreword by Peter Doherty
  • Book:
    Olfaction and the Brain
    Published online:
    17 August 2009
    Print publication:
    19 October 2006, pp 279-295

  • Summary

    The olfactory system is damaged to varying degree in the presence of clinically evident Parkinsonism. This chapter focuses on idiopathic Parkinson's disease (IPD) and familial Parkinsonism, as well as the known variants, Guam PD-dementia complex; Lewy body disease (LBD); multiple system atrophy (MSA), progressive supranuclear palsy (PSP), cortico-basal degeneration (CBD), drug induced PD (DIPD), vascular Parkinsonism (VP) and X-linked dystonia-Parkinsonism ('Lubag'). Patients with IPD have a profound disorder of olfactory function. This observation is based on pathological abnormality, psychophysical tests and evoked potential studies. Normal olfaction would favour essential tremor with the proviso that females with tremor-dominant IPD might also have a normal result. Degenerative syndromes with smell impairment may be split into two major categories that is, IPD, LBD, MSA where there is disorder of α-synuclein (alpha-synucleinopathy) and those with more normal olfaction that is, Alzheimer's disease, CBD and PSP where there is disorder of tau protein (tauopathy).