Vascular parkinsonism: 20 years later
Levin O.S.

Russian Medical Academy of Continuous Professional Education, Moscow

20 years ago author published review paper «Vascular parkinsonism». This article presents modern ideas about the clinical picture and the diagnosis of vascular parkinsonism (VP). The etiology of the disease, the features of the clinical course are considered in detail. Particular attention is paid to the clinical heterogeneity of the syndrome, the role of small arteries lesions in its pathogenesis, the establishment of a causal relationship between cerebral vascular pathology and clinical manifestations. The authors put forward criteria for diagnosis of VP, suitable for everyday clinical practice. The features of the course of the combination of Parkinson's and cerebrovascular disease are considered. Modern trends in the diagnosis of vascular parkinsonism treatment are given. Based on general clinical considerations, there are two main areas in the treatment of VP: basic therapy aimed at preventing further brain damage, and symptomatic therapy aimed at correcting parkinsonism and concomitant manifestations. The possibilities of stereotaxic interventions in VP have not been systematically studied yet. In some patients with limited basal ganglia lesions, they can be effective, but as the experience with stereotaxic interventions in multi-systemic degenerations shows, stereotaxic operations are often ineffective in extranigral forms of parkinsonism and multifocal brain damage.

Key words: parkinsonism, small vascular disease, vascular parkinsonism, dysbasia, levodopa.
For citation: Levin O.S. Vascular parkinsonism: 20 years later // RMJ. 2017. № 21. P. 1500–1506.