title: Improving the diagnostic accuracy in parkinsonism: a three-pronged approach.
abstract: Separating Parkinson's disease from the various causes of atypical parkinsonism (AP) is a common and clinically relevant challenge in clinical practice. Distinguishing between the different causes of AP is even more difficult. Here the authors discuss a systematic, clinically based and three-pronged approach that can assist clinicians in establishing the correct diagnosis in the consulting room. The three consecutive steps include: (1) to verify that the clinical syndrome truly represents parkinsonism (hypokinetic-rigid syndrome); (2) to search systematically for 'red flags' (alarm signs that may signal the presence of AP); and (3) to integrate these two steps, as a basis for a narrow differential diagnosis and a guide for further ancillary tests.
authors.affiliation: Department of Neurology, Parkinson Center Nijmegen (ParC), and Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marjolein B
authors.initials: MB
authors.lastname: Aerts
authors.forename: Rianne A J
authors.initials: RA
authors.lastname: Esselink
authors.forename: Bart
authors.initials: B
authors.lastname: Post
authors.forename: Bart P C
authors.initials: BP
authors.lastname: van de Warrenburg
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy