Vascular Parkinsonism: A Review of the Precision and Frequency of the DiagnosisFoltynie T.a · Barker R.a · Brayne C.b
aCambridge Centre for Brain Repair, and bInstitute of Public Health, University of Cambridge, Cambridge, UK
Over the past century vascular parkinsonism (VP) has been established, dismissed and recently re-established as a possible clinical entity. We review the clinical features that have been proposed to suggest the diagnosis and explore how precisely VP has been defined on the basis of clinical, as well as radiological and pathological grounds. Estimates of the frequency of this condition have been based on population-based incidence and prevalence studies and also using case series of all types or parkinsonism. We performed a systematic search for all of these published studies and present their estimates of frequency. We conclude that the wide variations in these estimates may be largely explicable by variation in case definition. When studies are limited to those with either imaging or pathological support for the diagnosis, all but one estimate that 3–6% of all cases of parkinsonism have a vascular cause. In addition, features of parkinsonism have been seen in up to 38% of lacunar stroke patients at 1 year. On the basis of this appreciably high frequency, and with consideration of the implications for clinician and scientist, we suggest that VP needs to be recognised as an important clinical diagnosis, and includes a spectrum of distinct pathophysiological entities.
© 2002 S. Karger AG, Basel
Thomas Foltynie, MRCP
Cambridge Centre for Brain Repair
University of Cambridge, Robinson Way
Cambridge, CB2 2PY (UK)
Tel. +44 1223 331160, Fax +44 1223 331174, E-Mail firstname.lastname@example.org
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 1, Number of References : 48
Founded 1982 by B.S. Schoenberg, continued by M. Alter (1989–1996)
Vol. 21, No. 1, Year 2002 (Cover Date: January-February 2002)
Journal Editor: G.C. Román, San Antonio, Tex.
ISSN: 0251–5350 (print), 1423–0208 (Online)
For additional information: http://www.karger.com/journals/ned