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Department of Medicine (Drs. Rajput, R. Pahwa, and P. Pahwa) and the College of Medicine (Alex Rajput), University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Early recognition of the prognosis in parkinsonism is important for both the management and studies aimed at preventing progression of disease. Less favorable prognosis is reported in early-onset postural instability and gait difficulty (PIGD) than in the tremor-onset cases, but the reasons for this are unknown. In 70 autopsy-verified cases, 11 (15.7%) had PIGD, and 34 (49%) had tremor onset. Improvement on levodopa was more common in the tremor- than the PIGD-onset cases (p < 0.05). The majority of tremor-onset cases had Lewy body disease, while the majority of PIGD-onset cases had other forms of pathology. Survival was shorter in the PIGD- than the tremor-onset cases (p < 0.05).
Address correspondence and reprint requests to Dr. AH H. Rajput, Department of Medicine
(Neurology), Royal University Hospital, Saskatoon, Saskatchewan, Canada S7N 0X0.
Supported by a grant from the Saskatchewan Parkinson's Disease Foundation.
Received July 7, 1992. Accepted for publication in final form August 27, 1992.
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