Parkinsonism and Its Clinical Subtypes - An Observational Study in a Tertiary Care Hospital

Abstract

Background: The term Parkinsonism is defined by any combination of six specific motor features: tremors at rest, bradykinesia, rigidity, loss of postural reflexes, flexed posture, and the freezing phenomenon (where the feet are transiently “glued to the ground”). Not all six of these cardinal features need be present, but at least two should be before the diagnosis of Parkinsonism is made, with at least one of them being tremors at rest or bradykinesia. This study is a hospital based Observational study to understand the prevalence and rank order of subtypes of Parkinsonism. Material and Method: Subjects are enrolled after written and informed consent. Details were recorded in a predesigned proforma after detailed history and clinical examination. If the patient was found to have akinetic rigid state/features of Parkinsonism, detailed history relevant to various Parkinsonian syndromes were taken to know the kind of Parkinsonian syndrome he/she belongs to. Standard criteria of each of the Parkinsonian syndromes are applied to confirm about the type of Parkinsonian syndrome the patient is suffering with. Data entered and analysed in Microsoft Excel 2007 and presented in the form of frequencies and percentages. Results: The prevalence of Parkinsonism in this study is 42 per 10000 population. The different types of Parkinsonism in the order high to low are Idiopathic Parkinson’s Disease (62.50%), Progressive Supranuclear Palsy (16.67%), Vascular Parkinsons Disease (12.50%), Multi System Atrophy (3.33%), Cortico-Basal Degeneration (2.50%), Drug induced Parkinsons Disease (1.67%) and Dementia with Lewy
Bodies (0.83%). Conclusions: A total of 120 patients were found to have features of Parkinsonism out of 28800 patients. The prevalence of Parkinsonism in this study is 42 per 10000 population.