I located an article entitled "Differential Diagnosis of Parkinson's Disease and the Parkinsonism Plus Syndromes" by Mark Stacy, MD (Dept of Neurology, U of Missouri, School of Med, Columbia, MO) and Joseph Jankovic, MD (Dept of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX) that was published in _Neuological Clinics_, Volume 10, Number 2, May 1992, pages 341-359. Does anyone know how to import this article for review by our PARKINSN list members? They say: "... The second largest group of parkinsonian disorders (12% of all parkinsonian patiets seen at [Baylor] is classified clinically as parkinsonism plus syndromes and pathologically as multiple system degenerations [MSA = Multiple System Atrophy is a common term in many pieces I've seen]... The lack of improvement with levadopa [sinemet] or dopamine agonists may be partly explained by fundamental differences in the density of the postsynaptic dopamine receptors. These receptors are preserved in Parkinson's disease, but are usually decreased in the other parkinsonian disorders. This article focuses only on the sporadic (non-genetic) forms of multiple system degenerations." Table 3 is particularly good and I'll try to copy it here. It is a matrix of symptoms vs. syndromes. I will use the following convention: Y=yes, usually a symptom, N=not usually, B=may or may not be a symptom Table 3. Differential Diagnosis of Parkinsonism Plus Syndromes PD PSP SDS SND OPCA CBGA ADP PDCG/ALS -- --- --- --- ---- ---- --- -------- Bradykinesia Y Y Y Y B Y B Y Rigidity Y Y Y Y Y Y B Y Gait disturbance Y Y Y Y Y Y B Y Tremor Y N N N B B N Y Ataxia N N B N Y N N B Dysautonomia B B Y B B N N B Dementia B Y B N N B Y Y Dysarthria/dysphagia B Y B Y Y Y B Y Dystonia B B N B N Y N N Eyelid apraxia N Y N B N B N N Limb apraxia N N N N N Y B N Motor neuron disease N N B B N N N Y Myoclonus B N N N N Y B N Neuropathy N N B N B N N N Oculomotility disturbance N Y B N Y Y B N Orthostatic hypotention B B Y B B N N N Sleep abnormalities B B Y B B N N N Asymmetric findings Y N N N N Y N N Levodopa response Y B B B N N N N where PD = Parkinson'd Disease; PSP = progressive supranuclear palsy; SDS = Shy-Drager syndrome; SND = striatonigral degeneration; OPCA = olivopontocerebellar atrophy; CBGD = corticobasal ganglionic degeneration; ADP = Alzheimer's disease with parkinsonism; PDCG/ALS = parkinsonism-dementia-amyotrophic lateral sclerosis complex of Guam. Makes me really appreciate an electronic file when it's available. Thanks to whomever types all that stuff in. ------------------------------------------------ John DeGelleke ([log in to unmask]) ([log in to unmask] after 1/31/95) Palm Harbor, FL ------------------------------------------------