Primitive reflexes distinguish vascular parkinsonism from Parkinson's disease.
OBJECTIVE
Although vascular parkinsonism (VP) occurs frequently in the elderly, its clinical features have not been investigated in detail, particularly in comparison with Parkinson's disease (PD). The goal of this study is to clarify the diagnostic value of pathological reflexes in differentiating between VP and PD.


METHODS
In 132 patients with PD and 55 with VP, pathological reflexes, including snout reflex (SR), palmomental reflex (PMR), corneomandibular reflex (CMR), jaw reflex (JR), Hoffmann reflex (HR), and extensor plantar response (EPR), were evaluated.


RESULTS
The percentage of each pathological reflex elicited in two groups (VP:PD) was as follows: SR (78:30), PMR (53:26), CMR (9:6), JR (33:12), HR (29:11), and EPR (25:8). The prevalence of pathological reflexes, except for CMR, was significantly higher in the VP patients than in the PD patients. In particular, SR and PMR were more frequent than upper motor neuron signs in the VP patients. The sensitivity and specificity of either SR or PMR for VP were 84% and 82%.


CONCLUSIONS
Snout and palmomental reflexes are useful tools in the differentiation between VP and PD.
Okuda
Bungo
B
Department of Neurology, Ehime Prefectural Central Hospital, Matsuyama, Japan. c-okuda@eph.pref.ehime.jp <c-okuda@eph.pref.ehime.jp>
Kawabata
Keita
K
Tachibana
Hisao
H
Kamogawa
Kenji
K
Okamoto
Kensho
K
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009046:Motor Neurons / Q000502:physiology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D012018:Reflex / Q000502:physiology*
D000978:Antiparkinson Agents; D007980:Levodopa