Acute challenge with apomorphine and levodopa in parkinsonism

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Although the recognition of a parkinsonian syndrome may be immediate, the clinical diagnosis of idiopathic Parkinson's disease (PD) remains difficult, due to the lack of specific biological markers. Other parkinsonian syndromes may present with similar clinical features and clinical diagnostic errors Alberto Albanese have been demonstrated in pathological series [1]. Approximately 75% of patients seen at movement disorder clinics exhibit the typical features of PD [2]; they may respond favorably to dopaminergic treatment and are likely to receive a clinical diagnosis of PD. Still, the diagnosis of PD is confirmed pathologically in only about 75% of these patients [1]. Response to antiparkinsonian medication is closely related to the diagnosis. PD always responds (often dramatically) to treatment with levodopa or dopamine agonists. Thus, a lack or loss of response to levodopa is considered incompatible with a diagnosis of PD [1, 3] and has been used as a criterion for the diagnosis of multiple-system atrophy (MSA) [4]. However, parkinsonian syndromes other than PD (e.g., drug-induced parkinsonism, MSA, autosomal recessive juvenile parkinsonism) may also improve significantly with dopaminergic drugs [3, 5-8].

Original languageEnglish
Pages (from-to)60-63
Number of pages4
JournalFocus on Parkinson's Disease
Issue number3
Publication statusPublished - 2001

ASJC Scopus subject areas

  • Clinical Neurology


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