The diagnosis of Parkinson's disease (PD) requires ruling out other causes of parkinsonism. Some findings should raise doubts about the diagnosis of PD, and other disorders should be considered instead, whenever any of these are observed.
Red flags for an incorrect diagnosis of Parkinson’s Disease Absence of symptom asymmetry Severe axial or lower limb involvement, especially in early stages Frequent falls, especially in early stages Fast disease progression (e.g., Hoehn and Yahr stage 3 in less than 3 years) Eye movement disorders (e.g., supranuclear palsy, dysmetric or slow saccades) Other unexpected movement disorder, such as myoclonus, tics, and chorea Pyramidal or cerebellar dysfunction Bulbar or pseudobulbar features Parietal associative sensory disturbances (agraphesthesia, astereognosis) Apraxia Alien limb Severe cognitive deterioration or psychosis early in disease course…
