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Distinguishing features of parkinsonian syndromes

Distinguishing features of parkinsonian syndromes
  Corticobasal degeneration Progressive supranuclear palsy Parkinson disease Multiple system atrophy
Age at onset, years 45 to 77[1] 65 to 75 65 to 80 50 to 60
Resting tremor No No Characteristic Sometimes
Action tremor Sometimes No Sometimes Yes
Asymmetry Characteristic No Frequent No
Dystonia Focal Axial Sometimes Bilateral
Memory Sometimes Sometimes Sometimes Sometimes
Aphasia Often No No No
Apraxia Characteristic Sometimes No No
Alien hand Characteristic No No No
Behavior Disinhibited Apathetic or disinhibited Impulsive No
Cognitive Parietal Slowing, dysexecutive Dysexecutive Dysexecutive and others
Autonomic No No Moderate Severe
Gaze palsy Often Characteristic No Sometimes
Pseudobulbar Sometimes Yes No No
Falls Later Earlier Later Earlier
Duration (median) 6 to 8 years 6 to 12 years 6 to 22 years 6 to 10 years
Reference:
  1. Armstrong MJ, Litvan I, Lang AE, et al. Criteria for the diagnosis of corticobasal degeneration. Neurology 2013; 80:496.
Adapted with permission from: Kertesz A, Fealey RD, Keegan BM, Parisi JE. A 74-year-old woman with progressive right-hand tremor and inability to use her right side. Neurology 2009; 73:1399. Copyright © 2009 Lippincott Williams & Wilkins.
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