Table 12.2-2. Differentiation of parkinsonian syndromes

Parkinson disease

Bradykinesia, tremor, muscular rigidity, asymmetry of symptoms

Progressive supranuclear palsy

Progressive course, age of onset >40 years, supranuclear gaze palsy, early onset of falls, symmetric axial muscular rigidity, bradykinesia, bulbar symptoms

Multiple system atrophy

Autonomic disturbances, parkinsonism, poor or unsustained response to levodopa therapy, cerebellar signs, upper motor neuron findings

Adapted from Neurologist. 2008 Mar;14(2):79-88.