Differentiating Parkinson Disease From Traumatic Encephalopathy Syndrome

Congratulations Drs. Nita Chen, Lauren Fanty, Ariane Veilleux Carpentier, Michael S. Okun on the publication of “Differentiating Parkinson Disease From Traumatic Encephalopathy Syndrome,” which appears in the September 25th issue of Neurology Education and it contains a Tweetable Teaching Image (see below)

The recent publication detailing Muhammad Ali’s clinical diagnosis of levodopa-responsive young-onset Parkinson disease¹ has provided an educational opportunity for clinicians and trainees to enhance their diagnostic acumen, especially when encountering cases with a history of head trauma. A clinical diagnosis of Parkinson disease is usually made in patients with progressive bilateral asymmetric levodopa-responsive features accompanied by motor and nonmotor symptoms with or without resting tremor, with or without a history of traumatic brain injury. By contrast, progressive cognitive impairment after multiple repetitive impacts to the head, with or without neurobehavioral dysregulation, with or without a postural action tremor (which may be transitory), more commonly leads to a diagnosis of traumatic encephalopathy syndrome. This teaching aid can be used to highlight these important features and to illustrate that it is possible for the syndromes to co-occur inclusive of their respective pathologies. Finally, all clinicians should appreciate that head trauma is a risk factor for the later occurrence of Parkinson disease.