Parkinsonism

Complete Parkinsonism reference — PD diagnosis, LED calculator, MSA, PSP, DLB, motor complications, akinetic crisis, DBS, hospital safety. NICE NG71 · MDS criteria.

IMPORTANT: This app is intended for use by qualified healthcare professionals only. Always seek the advice of a qualified clinician before making any medical or prescribing decisions.

Parkinsonism Clinical Guide is a comprehensive evidence-based reference for the diagnosis and management of Parkinson's disease and related disorders. Built for neurologists, geriatricians, movement disorder specialists, and allied health professionals.

PARKINSON'S DISEASE DIAGNOSIS

• MDS Clinical Diagnostic Criteria 2015 - three-step approach
• UK Parkinson's Disease Society Brain Bank Criteria - full exclusion and supportive criteria
• Absolute exclusion criteria and red flags suggesting atypical parkinsonism
• Supportive features increasing diagnostic confidence
• Investigations: DaTscan, MIBG scintigraphy, olfactory testing, levodopa challenge
• Tremor differential diagnosis - PD vs essential tremor vs cerebellar vs dystonic

PARKINSONISM OVERVIEW

• Classification table: idiopathic PD, atypical, drug-induced, vascular, NPH, genetic
• Tremor differential: 6 types with distinguishing features
• Young-onset parkinsonism: Wilson's disease, LRRK2, Parkin, GBA, dopa-responsive dystonia

DRUG TREATMENT

• Levodopa: co-careldopa and co-beneldopa with full dosing protocols
• Dispersible levodopa for early morning akinesia and rescue doses
• Dopamine agonists: pramipexole, ropinirole, rotigotine patch, apomorphine SC
• Impulse control disorder warning and screening at every visit
• MAO-B inhibitors: rasagiline (ADAGIO trial), selegiline, safinamide (SETTLE trial)
• COMT inhibitors
• Amantadine: only licensed anti-dyskinesia drug - Gocovri extended release
• Interactive LED (Levodopa Equivalent Dose) conversion table - 14 drug factors
• Treatment strategy per NICE NG71

MOTOR COMPLICATIONS

• Wearing off: recognition, Hauser diary, 7-step management protocol
• Dyskinesia types: peak-dose, diphasic, off-period dystonia - comparison table
• On-Off fluctuations: apomorphine rescue, LCIG, Produodopa
• Freezing of gait

ATYPICAL PARKINSONISM

• Full comparison table: MSA, PSP, CBS, DLB

DRUG-INDUCED PARKINSONISM

• Eight drug classes causing Parkinsonism with risk levels
• DIP vs PD comparison table including DaTscan findings
• Safe antiemetics in PD: domperidone and ondansetron
• 30 percent of DIP unmasks underlying PD - when to perform DaTscan

NON-MOTOR FEATURES

• Autonomics
• Cognitive
• Sleep issues
• Psychiatric
• Safe antipsychotics

PARKINSON'S CRISIS

• Akinetic crisis: causes, 9-step ICU emergency protocol, apomorphine infusion
• NMS vs akinetic crisis: comparison table and treatment differences
• Dantrolene and bromocriptine protocols for NMS
• Dopamine dysregulation syndrome: recognition and management

SURGICAL TREATMENT

• DBS: STIM trial outcomes, STN vs GPi comparison, indications and contraindications
• HIFU MRgFUS: NICE approval, skull density ratio, thalamotomy outcomes
• Surgical target comparison: STN, GPi, Vim, zona incerta
• Ideal DBS candidate criteria - full checklist

PARKINSON'S IN HOSPITAL

• NEVER omit list: 6 drug classes with reasons and consequences
• NBM management: 6-step protocol including rotigotine patch and apomorphine
• Perioperative management: timing, anaesthetic considerations
• Drugs to AVOID in PD: full table with alternatives
• Safe antiemetics and safe antipsychotics for inpatients

SOURCES AND REFERENCES 25 plus tappable references including NICE NG71, MDS Diagnostic Criteria 2015, UK Brain Bank Criteria, McKeith DLB Criteria 2017, PSP MDS Criteria 2017, STIM trial, PD MED trial, ADAGIO trial, BIPARK trial, LED conversion table, REGAIN eculizumab trial, MRgFUS thalamotomy trial and Parkinson's UK hospital guidelines.

DISCLAIMER This app is intended for use by qualified healthcare professionals only as a clinical decision-support and educational reference tool. It does not replace individual clinical assessment, local neurology protocols or official prescribing information.