title: Ten steps to identify atypical parkinsonism.
abstract: BACKGROUND
  Balance impairment is a frequently encountered problem in patients with Parkinson's disease. A profound balance disorder, however, is an atypical feature.
  
  
  METHODS
  Tandem gait performance (10 consecutive tandem steps) was judged in 36 consecutive patients with Parkinson's disease and 49 consecutive patients with atypical parkinsonism.
  
  
  RESULTS
  Only 9 (18%) patients with atypical parkinsonism had a fully normal tandem gait (not a single side step) as opposed to 33 (92%) patients with Parkinson's disease. Analysis for the subgroup of patients with a disease duration of <3 years yielded the same diagnostic accuracy.
  
  
  CONCLUSIONS
  Tandem gait performance has a good diagnostic ability to differentiate patients with atypical parkinsonism from those with Parkinson's disease, and might be used as an additional "red flag" to assist existing clinical tests in identifying atypical parkinsonism.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
authors.forename: W F
authors.initials: WF
authors.lastname: Abdo
authors.forename: G F
authors.initials: GF
authors.lastname: Borm
authors.forename: M
authors.initials: M
authors.lastname: Munneke
authors.forename: M M
authors.initials: MM
authors.lastname: Verbeek
authors.forename: R A J
authors.initials: RA
authors.lastname: Esselink
authors.forename: B R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis*; D020734:Parkinsonian Disorders / Q000150:complications* / Q000175:diagnosis*; D004856:Postural Balance; D011446:Prospective Studies; D012680:Sensitivity and Specificity