Suspect Parkinson’s

<ul style='color:white; margin: 6px 0 0 14px; padding: 0; font-size: 12px; line-height: 1.2;'><li>Rest tremor</li><li>Slowness/stiffness</li><li>Gait disorders</li></ul>

IDENTIFY

Referral to specialist

Consider possibility of atypical parkinsonism

<ul style='color:white; margin: 6px 0 0 14px; padding: 0; font-size: 12px; line-height: 1.2;'><li>Early falls</li><li>Poor response to levodopa</li><li>Symmetry at onset</li><li>Rapid progression</li><li>Lack of tremor</li><li>Prominent dysautonomia</li></ul>

DIAGNOSIS

No confirmatory tests available (Discuss option of brain donation)

Predictors of more benign course<ul style='color:white; margin: 6px 0 0 14px; padding: 0; font-size: 12px; line-height: 1.2;'><li>Younger onset</li><li>Rest tremor</li></ul>

Predictors of more rapid course<ul style='color:white; margin: 6px 0 0 14px; padding: 0; font-size: 12px; line-height: 1.2;'><li>Older onset and rigidity/hypokinesia</li><li>Postural instability/Freezing gait</li><li>Dementia</li><li>Associated comorbidities</li><li>Male sex</li><li>Poor levodopa response</li></ul>

PROGNOSIS

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