This clinical article includes discussion of Vascular parkinsonism. -ed.
Parkinson disease is most often thought of as a condition that produces resting tremor, bradykinesia, and a festinating, propulsive gait disorder. As the disease advances, though, a number of other problems develop. These other manifestations are wide-ranging and include dysarthria, dysphagia, truncal flexion, a freezing gait disorder, dysautonomia, depression, apathy, psychosis, and dementia. In patients with longstanding Parkinson disease, these symptoms and features become the most noticeable and disabling aspects of the disease. In this clinical article, the clinical features, underlying neuropathology, and medical and surgical treatments of these later-stage features are discussed.