| Syndrome |
๐ Key Features |
๐ต๏ธ Diagnostic Clues |
๐ Management |
| ๐ Progressive Supranuclear Palsy (PSP) |
Vertical gaze palsy (โ gaze early), early backward falls, axial > limb rigidity, frontal lobe dysfunction, early dysarthria & dysphagia. |
MRI โHummingbird signโ; vertical gaze palsy is hallmark. |
Poor levodopa response; physio/OT for balance, speech & swallow therapy, supportive MDT care. |
| ๐ซ Multiple System Atrophy (MSA) |
Early autonomic failure (orthostatic hypotension, incontinence), symmetrical parkinsonism, cerebellar ataxia, dysarthria/dysphagia, pyramidal signs. |
MRI โHot cross bun signโ; autonomic dysfunction is key clue. |
Poor levodopa response; midodrine/fludrocortisone for OH, bladder care (catheterisation), physio & supportive rehab. |
| โ Corticobasal Degeneration (CBD) |
Asymmetric parkinsonism, alien limb phenomenon, cortical sensory loss, dystonia, apraxia, cognitive decline. |
Markedly asymmetric limb involvement; poor levodopa response. |
Levodopa usually ineffective; physio/OT for limb control, speech therapy, supportive MDT input. |
| ๐ Lewy Body Dementia (LBD) |
Early dementia (attention, visuospatial, executive), recurrent visual hallucinations, fluctuating cognition, parkinsonism, REM sleep behaviour disorder. |
Dementia develops within 1 yr of parkinsonism; levodopa may worsen hallucinations. |
AChE inhibitors (rivastigmine); avoid antipsychotics โ ๏ธ (esp. haloperidol); cautious levodopa; melatonin/clonazepam for sleep. |