Orginal Publication Date
MCV/Q, Medical College of Virginia Quarterly
In the management of Parkinson’s disease, one must be reasonably certain of the diagnosis. In spite of the foregoing sophisticated biochemistry, there is really no laboratory test for the disease, so it becomes an entity that must be recognized on purely clinical grounds. While the differential diagnosis can be quite extensive and includes such rare entities as manganese poisoning, as well as such usually apparent causes as phenothiazine intoxication or carbon monoxide sequelae, several disorders and etiologies account for most of our diagnostic problems. Although we think of Parkinsonism as a triad of rest tremor, rigidity, and akinesia, the onset may be with any one of these, and if it is with tremor, the distinction from essential tremor may be difficult.
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