Differential diagnosis of parkinsonism with visual inspection of posture and gait in the early stage.
BACKGROUND
Parkinson's disease (PD) differs from atypical parkinsonism in many clinical aspects. Principally, posture and gait are distinct features in the early stages of the disease; thus, these differences can be helpful in differential diagnosis.


METHODS
We analyzed videos of patients with PD or atypical parkinsonism. A total of 76 patients with early PD (n=56) or atypical parkinsonism (n=20) were included. Items related to posture and gait were classified into three categories (standing, gait and associated symptoms) and each sub-item was analyzed.


RESULTS
Asymmetric arm-swing (p=0.004) and accompanying tremor (p=0.016) were significant indicators of early-stage PD. Staggering gait (p=0.007) and en-bloc turning (p=0.026) were more common in atypical parkinsonism. Characteristics with a high odds-ratio for atypical parkinsonism were en-bloc turning (β=8.475, p=0.032) and normal arm-swing (β=14.6084, p=0.036).


CONCLUSIONS
Visual inspection of gait and posture provides reliable clues in the differential diagnosis of parkinsonism.
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Seon-Min
SM
Lee
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Minjik
M
Kim
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Hye Mi
HM
Lee
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Kyum-Yil
KY
Kwon
Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Hee-Tae
HT
Kim
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: parkinson@korea.ac.kr.
Seong-Beom
SB
Koh
D000368:Aged; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D014202:Tremor / Q000503:physiopathology; D034941:Upper Extremity / Q000503:physiopathology; D014741:Video Recording
Arm-swing; Atypical parkinsonism; Early stage; Parkinson's disease