Talk:Parkinson plus syndrome

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Who is the intended reader of this article and other medical articles? If the purpose is to be accessible and useful to a layperson, it would probably be better to describe symptoms as (for example)

difficulty with balance and coordination of the legs and arms (ataxia)

rather than "cerebellar ataxia" --Sjsilverman 23:40, 21 December 2005 (UTC)

Does olivopontocerebellar atrophy (OPCA) still exist? JFW | T@lk 15:33, 19 September 2005 (UTC)

In my 12 months as a neurology trainee I haven't heard it mentioned in the differential of Parkinson-Plus. I imagine it does exist as a pathological entity but is no longer diagnosed clinically. I do notice that a lot of MSA patients are having karyotypes for fragile X syndrome - this may be worth mentioning. Dubbin 21:21, 19 September 2005 (UTC) Dubbin

It appears to. See site Elsewhere it is described as a parkinsons plus disease. See Movement Disorders Group I've provisionally adde it here. --Sjsilverman 23:40, 21 December 2005 (UTC)

I suppose this page should mention the diagnostic workup. Does your institution still believe in Shy-Drager? JFW | T@lk 17:38, 20 September 2005 (UTC)

Shy-Drager is something I've been accustomed to treat as a synonym for MSA (of any combination of its possible features). A recent edit to the page suggested its being MSA with autonomic failure, which I am entirely prepared to accept. As to workup, this perhaps depends too heavily on the particular features of the P+ syndrome, as well as the institution, individual clinician and degree of diagnostic uncertainty. Might listing all possible investigations create shopping lists for worried patients? Dubbin 20:58, 20 September 2005 (UTC)

I avoid this conundrum by phrasing it: "the diagnosis is typically made with blah blah; doctors may also request blah blah and blah". Patients should not have a shopping list, but their clinician may need to justify why he/she has not performed a karyogram on them (e.g. because FXS would be unlikely in a female patient, or something in that vein). JFW | T@lk 18:05, 21 September 2005 (UTC)