Second edition

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88 Abnormal movements
Table 3.8 Causes of parkinsonism
Neurodegenerative disorders
Parkinson’s disease (Hughes et al., 1993; Martin et al. 1973)
Diffuse Lewy body disease (Byrne et al. 1989; Hely et al. 1996)
Multiple system atrophy (Watanabe et al. 2002; Wenning
et al. 1995)
Progressive supranuclear palsy (Collins et al. 1995; Litvan et al.
1996; Maher and Lees 1986; Nath et al. 2003)
Corticobasal ganglionic degeneration (Litvan et al. 1997b; Rinne
et al. 1994)
Frontotemporal dementia with parkinsonism linked to chromosome
17 (Boeve et al. 2005; Yasuda et al. 2005)
Dentatorubropallidoluysian atrophy (Warner et al. 1995)
Neuroacanthocytosis (Hardie et al. 1991)
Wilson’s disease (Starosta-Rubinstein et al. 1987)
Fahr’s syndrome (Klawans et al. 1976b; Tambyah et al. 1993)
Alzheimer’s disease (Clark et al. 1997; Goodman 1953; Scarmeas
et al. 2004)
Hallervorden–Spatz disease (Alberca et al. 1987; Jankovic et al. 1985)
Juvenile-onset Huntington’s disease (Bird and Paulson 1971;
Campbell et al. 1961; Siesling et al. 1997)
Kufs’ disease (Nijssen et al. 2002)
Lubag (Evidente et al. 2002)
Spinocerebellar ataxia (Furtado et al. 2002; Shan et al. 2001)
Rapid onset dystonia parkinsonism (Brashear et al. 1996, 1997, 2007;
Kabacki et al. 2005; Kramer et al. 1999; Pittock et al. 2000)
Hereditary mental depression and parkinsonism (Perry et al. 1975;
Tsuboi et al. 2002)
Guamian amyotrophic lateral sclerosis–parkinsonism complex
(Garruto et al. 1981; Hirano et al. 1967; Malamud et al. 1961)
Secondary to medications
Antipsychotics (Hardie and Lees 1988)
Metoclopramide (Indo et al. 1982; Sethi et al. 1989)
Prochlorperazine (Edelstein and Knight 1987)
Neuroleptic malignant syndrome (Rosebush and Stewart 1989;
Velamoor et al. 1994)
Valproic acid (Armon et al. 1996; Easterford et al. 2004; Iijima
et al. 2002)
Alpha-methyldopa (Strang 1966)
Lithium (Holroyd and Smith 1995)
Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine [Ernst
and Steur 1993], paroxetine [Jimenez-Jimenez et al. 1994])
Phenelzine (Teusink et al. 1984)
Calcium channel blockers (e.g., cinnarizine, flunarazine, amlodipine
[Marti-Masso and Poza 1998; Sempere et al. 1995])
MPTP, methylphenyltetrahydropyridine.
to toxins and substances of abuse, such as methanol.
Following this, there is a group of cases secondary to other,
more or less obvious, precipitating events, such as repeated
head trauma, or anoxia. Finally, there is a group of miscellaneous
causes, prominent among which are stroke and the
controversial entity known as ‘vascular parkinsonism’.
Among the neurodegenerative disorders, Parkinson’s
disease, in addition to being the most common, is also the
Amiodarone (Werner and Olanow 1989)
Disulfiram (de Mari et al. 1993; Laplane et al. 1992)
Budesonide (Prodan et al. 2006)
Cytosine arabinoside (Luque et al. 1987)
Kava extract (Meseguer et al. 2002)
Secondary to toxins and substances of abuse
Alcohol withdrawal (Carlen et al. 1981)
Methanol (Guggenheim et al. 1971; McLean et al. 1980;
Verslegers et al. 1988)
MPTP (Ballard et al. 1985; Tetrud et al. 1989)
Inhalant abuse (Uitti et al. 1994)
Manganese (Abd El Naby and Hassanein 1965; Huang et al.
1989)
Cyanide poisoning (Uitti et al. 1985)
Diquat (Sechi et al. 1992)
Organophosphates (Bhatt et al. 1999)
Secondary to other precipitating events
Dementia pugilistica (Harvey and Davis 1974; Martland
1928)
Post-anoxic encephalopathy (Bhatt et al. 1993; Bucher et al.
1996; Goto et al. 1997)
Carbon monoxide poisoning (Choi 1983; Grinker 1926;
Klawans et al. 1982b)
Encephalitis lethargica (Duvoisin and Yahr 1965; Rail et al.
1981)
Arbovirus encephalitis (e.g., western equine [Mulder et al.
1951; Schultz et al. 1977], Japanese [Pradhan et al. 1999])
Miscellaneous causes
Stroke (see text for references)
‘Arteriosclerotic parkinsonism’ (Murrow et al. 1990)
Acquired hepatocerebral degeneration (Burkhard et al. 2003)
Hepatic encephalopathy (Federico and Zochodne 2001)
‘Encephalopathic’ pellagra (Serdaru et al. 1988)
Central pontine myelinolysis (Dickoff et al. 1988; Tomita
et al. 1997)
Multiple sclerosis (Federlein et al. 1997)
Hydrocephalus (Racette et al. 2004)
Systemic lupus erythematosus (Dennis et al. 1992)
Sjögren’s syndrome (Walker et al. 1999)
Acquired immune deficiency syndrome (AIDS) (Hersh et al.
2001)
Neurosyphilis (Sandyk 1983)
Hypoparathyroidism (Stuerenburg et al. 1996)
most likely to cause ‘classic’ parkinsonism as described
above. Onset is typically with tremor, with or without
rigidity, or less commonly with rigidity alone; symptoms
generally appear unilaterally, typically in one of the upper
extremities, and over time spread occurs in a gradual fashion
to involve the contralateral extremity and, eventually,
all four extremities. The classic picture may also be more or
less faithfully imitated by diffuse Lewy body disease and