Clinicopathological Conference Clinicopathological Conference CPC #7CPC #7

Feb 26, 2008Feb 26, 2008The Johns Hopkins HospitalThe Johns Hopkins Hospital

Hurd HallHurd Hall12 Noon12 Noon

Clinical Discussant: Zoltan Mari, MD Clinical Discussant: Zoltan Mari, MD Radiologist: Doris Lin, MDRadiologist: Doris Lin, MD

Pathology Resident: Lisa Stoll, MD, MPHPathology Resident: Lisa Stoll, MD, MPHModerator: Charles Wiener, MDModerator: Charles Wiener, MD

Zoltan Mari, M.D.Zoltan Mari, M.D.Assistant Professor in NeurologyAssistant Professor in Neurology

Johns Hopkins University School of MedicineJohns Hopkins University School of Medicine

My Contact InfoMy Contact Info

• Email: zmari1@jhmi.eduEmail: zmari1@jhmi.edu

• Mail: 600 N. Wolfe Street, Meyer 6-119B, Mail: 600 N. Wolfe Street, Meyer 6-119B, Baltimore, MD 21287Baltimore, MD 21287

• Phone: 410-502-0133 (Rebecca Williams)Phone: 410-502-0133 (Rebecca Williams)

• Fax: 410-502-0570Fax: 410-502-0570• Web: Web: http://www.hopkinsneuro.org/movement%5Fdisorders/doc.cfm?i=136http://www.hopkinsneuro.org/movement%5Fdisorders/doc.cfm?i=136

OverviewOverview

• Patient PresentationPatient Presentation

• Differential DiagnosisDifferential Diagnosis

• Secondary Causes of ParkinsonismSecondary Causes of Parkinsonism

Patient PresentationPatient Presentation

• Chief Complaint: Unsteady GaitChief Complaint: Unsteady Gait

• HOPIHOPI

• Exam and WorkupExam and Workup

• Clinical CourseClinical Course

• SummarySummary

Differential DiagnosisDifferential Diagnosis

• ParkinsonismParkinsonism

• WeaknessWeakness– NeuronopathyNeuronopathy

– ALSALS

– LymeLyme

– NeurosyphilisNeurosyphilis

• Psychiatric IllnessPsychiatric Illness– CatatoniaCatatonia

– DepressionDepression

– Conversion disorderConversion disorder

• AtaxiaAtaxia

• DemyelinationDemyelination

Secondary Causes of ParkinsonismSecondary Causes of Parkinsonism

• Drug-Induced ParkinsonismDrug-Induced Parkinsonism

• Toxic ParkinsonismToxic Parkinsonism

• Parkinsonism due to Structural LesionsParkinsonism due to Structural Lesions

• Infectious ParkinsonismInfectious Parkinsonism

• Metabolic ParkinsonismMetabolic Parkinsonism

• Post-Traumatic ParkinsonismPost-Traumatic Parkinsonism