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Atypical Parkinsonian Disorders: Clinical and Research Aspects
edited by Irene Litvan, 512 pp., Humana Press, 2005, $175.00
For the neurologic clinician and even the seasoned movement disorder expert, accurate diagnosis of the atypical parkinsonian disorders has been a difficult proposition, especially when trying to provide a prognosis for the patient and family and devising a treatment strategy. This area of clinical care has been plagued by a lack of a specific biomarker for any of the parkinsonian disorders, including idiopathic parkinsonism. We have been stuck in the stage of correlating clinical phenotypes with pathology. Much of the recent progress has been driven by molecular histopathology and the discovery that these disorders can be classified according to whether there is an accumulation of alpha-synuclein (“synucleinopathy”) or tau protein (“tauopathy”). However, as Dr. Agid points out in his excellent forward, the best definition of atypical parkinsonism is still an anatomoclinical one because even a postmortem exam does not always yield an accurate histopathologic diagnosis and is of limited value to the patients and their caregivers. Nonetheless, the new …
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