Vascular parkinsonism: analysis of seven cases.

INTRODUCTION Neuroimaging studies of elderly individuals reveal alterations in the white matter that are incompatible with the patients parkinsonism, mistakenly classified as vascular parkinsonism (VP). METHOD This study was conducted on a population composed of 20 patients with Parkinsons disease (PD) whose neuroimaging exams revealed vascular alterations in the white matter and seven patients with VP in order to compare diagnostic criteria. RESULTS Age at disease onset of patients with PD was 55+/-12 years and patients with VP it was 62+/-13 years. Twelve patients with PD and five patients with VP presented arterial hypertension; three patients with VP and two patients with PD presented gait impairment; all patients with VP presented rigidity and bradykinesia, six of them presented resting tremor; 19 patients with PD presented tremor and 19 of them presented rigidity, while 17 presented bradykinesia. When the symptoms and evolution of both diseases were compared, the vascular alterations in the white matter were considered unspecific. CONCLUSION Since clinical symptoms are unspecific, a differential diagnosis requires neuroimaging, good response to levodopa and clinical evolution.