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----------------------------------------------------------------------- Parkinson "plus". ----------------------------------------------------------------------- "Parkinson plus" is a group of sporadic degenerative disorders associating Parkinsonism, poorly sensitive to L-dopa, to other neurological syndromes. Thus, progressive supranuclear palsy includes Parkinson's disease, vertical gaze paralysis, nuchal dystonia and dementia; multisystem atrophies associate to different degrees Parkinson's disease (striatonigral degeneration), a cerebellar syndrome (olivopontocerebellar atrophy), dysautonomia (Shy-Drager syndrome), pyramidal syndrome, etc. Other diseases (corticobasal degeneration, diffuse Lewy body disease) also belong to the Parkinson "plus" group. Clinical differentiation between Parkinson "plus" and idiopathic Parkinson's disease is difficult. Their prognosis and treatment are substantially different. Certain diagnosis is based solely upon anatomical observations. Rev Prat 1997 May 15;47(10):1077-1082 Fabre N, Brefel-Courbon C, Rascol O Service de neurologie et de pharmacologie medicale et clinique INSERM U 317 CHU Toulouse, France PMID: 9208670, MUID: 97352390 ----------------------------------------------------------------------- janet [log in to unmask]