A case of the development of early mental and autonomic disorders in a patient with Parkinson's disease. differential diagnosis with atypical parkinsonism

Parkinson's disease is a chronic progressive neurodegenerative disease characterized by early pronounced death of dopaminergic neurons in the compact substantia nigra with accumulation of intracellular pathological protein alpha-synuclein. It is often necessary to carry out differential diagnosis of this disease with atypical types of parkinsonism, such as multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and diffuse Lewy body disease. Given the fact that the diagnosis of all types of Parkinsonism basically consists in conducting a clinical examination, specialists often find it difficult to make the correct diagnosis. This article describes the differential diagnosis of Parkinson's disease and multiple system atrophy on the example of a clinical case. The purpose of studying this case is to help practitioners in making diagnoses of Parkinsonism. A patient with symptoms of Parkinsonism was examined, followed by differential diagnosis based on the obtained clinical and instrumental data. The verification of the diagnosis caused particular difficulty due to the presence of various combined symptoms of Parkinsonism. Ultimately, based on clinical and instrumental studies, the decision was made in favor of Parkinson's disease, which was confirmed by the fact of a positive response to Levodopa therapy. Undoubtedly, every practicing neurologist needs to know the clinical features of various types of parkinsonism in order to make a correct diagnosis, and, accordingly, prescribe the correct treatment in the future.