Dementia early in the course of parkinsonism represents an exclusion criteria for the diagnosis Parkinson's disease and multiple system atrophy. Dementia wit parkinsonism develops in progressive supronuclear palsy (PSP) and corticobasal degeneration (CBD). Parkinsonism together with dementia also occurs in a varierty of other conditions such as in diffuse Lewy-disease, late in the course of Alzheimer's disease, in vascular parkinsonism and normal pressure hydrocephalus. Parkinsonism plus dementia is a therapeutic challenge. Antiparkinsonian drugs commonly cause delirium and psychosis. Neuroleptics are contraindicated as they worsen parkinsonism. Cholinesterase inhibitors may play here a new role as recent studies show that these compounds are effective for the behavioural signs of dementia without worsening parkinsonism.
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Dementia early in the course of parkinsonism represents an exclusion criteria for the diagnosis Parkinson's disease and multiple system atrophy. Dementia wit parkinsonism develops in progressive supronuclear palsy (PSP) and corticobasal degeneration (CBD). Parkinsonism together with dementia also occurs in a varierty of other conditions such as in diffuse Lewy-disease, late in the course of Alzheimer's disease, in vascular parkinsonism and normal pressure hydrocephalus. Parkinsonism plus dementi...
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