Overview
The Pattern That Separates These Disorders
These three disorders can all produce difficulty walking, falls, weakness, and loss of independence, but the bedside pattern is different.
These three disorders can all produce difficulty walking, falls, weakness, and loss of independence, but the bedside pattern is different. | Feature | Parkinson disease | Guillain-Barré syndrome | Amyotrophic lateral sclerosis | |---|---|---|---| | Tempo | Chronic, progressive | Acute, usually days to weeks | Progressive, usually months to years | | Primary system | Basal ganglia and extrapyramidal motor circuits | Peripheral nerves and nerve roots | Upper and lower motor neurons | | Hallmark motor pattern | Bradykinesia plus rest tremor or rigidity | Symmetric weakness with reduced or absent reflexes | Weakness with a mixture of spasticity, brisk reflexes, wasting, and fasciculations | | Sensation | Usually preserved | Tingling, pain, or sensory symptoms may occur | Typically preserved | | Respiratory threat | Aspiration, dysphagia, medication-related immobility | Rapid neuromuscular respiratory failure | Gradual ventilatory muscle weakness | | Eye movements and sphincters | May be affected by disease complications | Autonomic and bladder dysfunction can occur | Extraocular movement and bowel or bladder control are usually spared | The quickest bedside discriminator is often...