Vascular parkinsonism in outpatient practice

Vascular parkinsonism (VP) refers to secondary parkinsonism: it develops with the damage of subcorticat nuclei, white substance of the deeper regions of brain hemispheres and is more common in older age group individuals. In our country overdiagnosis of vascular parkinsonism is often taking place, because neurologists have a strong conviction that parkinsonism has vascular genesis. The difficulty of vascular parkinsonism diagnosing is associated with insufficiently developed criteria of diagnostics, as well as the medical care organization imperfection. Incorrect diagnosis leads to non-compliance with treatment standards. The aim of the study is to identify clinical signs causing diagnostical errors of vascular parkinsonism, also estimation of the quality of outpatient care for patients. Material and methods. In the course of the study, 162 patients with movement disorders with various neurological diagnoses were examined for the period from 01/16/2016 to 06/31/2018. Results. The diagnosis of vascular parkinsonism was established in 34 (21%) cases; in 128 (79%) patients the diagnosis is worked out in details. Common errors in the curation of patients with vascular parkinsonism include: overdiagnosis, irrational prescription of levodopa, unreasonable use of vasoactive and nootropic medicaments, hospitalizations. Conclusion. The results can serve as a provement for the organization and performing of educational programs for primary care physicians on the issues of rational diagnosis and treatment of vascular parkinsonism.

vascular parkinsonism, Parkinson's disease, discirculatory encephalopathy