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Chapter 34 - Vascular Parkinsonism

from Section 2: - Hypokinetic Movement Disorders

Published online by Cambridge University Press:  07 January 2025

By
Erik Ch. Wolters
Edited by
Erik Ch. Wolters  and
Christian R. Baumann
Erik Ch. Wolters
Affiliation:
Universität Zürich
Christian R. Baumann
Affiliation:
Universität Zürich
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Summary

Vascular parkinsonism (VP) is a clinical entity within the broader context of parkinsonian syndromes and usually manifests with an array of clinical features including a mainly lower body motor parkinsonism with a gait disorder, corticospinal and pseudobulbar signs and symptoms, urinary incontinence, dementia, and pyramidal and cerebellar signs. As the name suggests, etiologically VP may be defined as a secondary parkinsonian syndrome occurring in relation to ischemic cerebrovascular disease. Treatment for VP remains challenging as available data on the efficacy of current treatment options are contentious. VP is generally considered to be poorly responsive to levodopa, the most effective of the current treatment modalities for parkinsonism; however, there is evidence that some patients benefit from therapy with levodopa, especially in case of underlying ischemic or hemorrhagic lesions in the substantia nigra, globus pallidus pars externa, thalamic ventral lateral nuclei, or nigrostriatal pathway, leading to presynaptic dopamine transporter deficiency as measured by single photon emission computed tomography.

Keywords

Vascular parkinsonismlower body-half parkinsonismcerebrovascular diseasedopamine transporter deficiency
Type
Chapter
Information
International Compendium of Movement Disorders , pp. 414 - 422
Publisher: Cambridge University Press
Print publication year: 2025

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