Pitfalls in diagnosis and treatment of Parkinsonism

Abstract

Parkinson's disease is the commonest disabling neurological condition after stroke. It is the name given to clinical syndrome comprising voluntary movement (hypokinesia), rigidity and tremor combined in some cases with such disorders as oculogyric crisis, psychiatric disturbance and dementia. Ifs incidence and prevalence have been little studied. The annual incidence rate (number of new cases per unit population per year) of an insidious condition like Parkinsonism can be unreliable, as many early cases can be missed. The prevalence rate (number of cases per unit population on a given date) is likely to be more informative, particularly in those studies where age-specific prevalence has been determined. There is reasonable agreement in studies in different countries over two decades that the prevalence rises with increasing age. The prevalence rate of 14/1000 in those aged 70-80, and 26/1000 in those aged 85 and over). The prevalence of idiopathic Parkinsonism in Europe and North America is approximately 1.5/1000, though in Japan and China the prevalence is approximately 0. 75/1000. Both sexes and all races are affected. With advancing years there is a steep rise in prevalence rates which may approach more than 1% of individuals aged 50 years or over. [...]