Diagnosing parkinsonism with atypical features: a classification system

Oscar Gershanik, MD, Favaloro University, Buenos Aires, Argentina, outlines the details of a proposed diagnostic classification system and a roadmap to correct diagnosis in patients with parkinsonian syndromes. The lack of objective, specific biomarkers for the differential diagnosis of Parkinson's disease means that patients are typically diagnosed using clinically defined criteria. Recognizing the challenges in the diagnosis of parkinsonism with atypical features, Prof. Gershanik shares a systematic approach to the diagnosis of parkinsonism, based on 5 categories. Firstly, cases can be classified as typical parkinsonism (classical presentation of idiopathic Parkinson’s disease) or atypical-typical parkinsonism (atypical presentation of typical parkinsonism). The next groups are typical-atypical parkinsonism (progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy) and atypical-typical-atypical (atypical presentation of typical-atypical parkinsonism). Finally, atypical-atypical parkinsonism includes all presentations that do not fit into the above categories. This interview took place during the 2021 International Congress of Parkinson's Disease and Movement Disorders.