Differential Diagnosis of Parkinson’s Disease and Multiple System Atrophy
The purpose of this study was the selection and description of the key differential diagnostic features and criteria for multiple system atrophy and Parkinson’s disease in order to improve the diagnosis and differential diagnosis of these diseases. A total of 205 patients with idiopathic Parkinson’s disease and 17 patients with multiple system atrophy had been examined. The severity of disease in patients with multiple system atrophy was significantly higher than in patients with Parkinson’s disease. Fall, freezing when walking, swallowing disorders, autonomic disorders, intellectual impairment, and depression occurred significantly more often in patients with multisystem atrophy compared with patients with Parkinson’s disease. Unlike Parkinson’s disease, in which the vast majority of cases (97.84 %) excellent, good or moderate effect of antiparkinsonian drugs was noted, in most patients with multiple system atrophy (73.33 %) only minor therapeutic effect was observed. Rapidly progressive autonomic dysfunction (not associated with any comorbidity) that developed shortly (1–2 years) before Parkinson’s disease, as well as onset of the disease with postural reflex impairment can be some of the distinctive features of multiple system atrophy.
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