DIFFERENTIAL DIAGNOSIS

Depression with its associated expressionless face, poorly modulated voice, reduction in voluntary activity: can be difficult to differentiate from parkinsonism.

Wilson’s disease can be identified by its early age at onset, presence of other abnormal movements, Kayser Fleischer rings, chronic hepatitis, increased concentrations of copper in tissues.

Huntington’s disease presenting with rigidity and bradykinesia may be mistaken for parkinsonism unless the family history and accompanying dementia are recognized.

In Shy Drager syndrome, clinical features of parkinsonism are accompanied with postural hypotension, anhidrosis[absence of sweating], disturbances of sphincter control etc. [autonomic insufficiency]
In progressive supranuclear palsy, disorders of eye movements, pseudobulbar palsy, and axial dystonia[postural abnormality] accompanies rigidity and bradykinesia.

Creutzfeldt – Jacob disease, dementia is usual, myoclonic jerking [sudden spasms of muscles] is common, electroencephalographic findings are characteristic.

In cortical – basal ganglionic degeneration; apraxia[inability to make skilled movements], sensory inattention, dementia and aphasia [disorder of speech and language] are common.