Mise au point sur le syndrome parkinsonien vasculaire

Vascular parkinsonism, initially described in 1929, is a currently controversial nosological entity, whose certain diagnosis is exclusively anatomopathological. Clinical presentation, often heterogeneous, typically associates: chiefly gait disorders, symmetrical parkinsonism with lower body predominance, early postural instability, cognitive disorders and pyramidal signs, and poor response to levodopa. Neuroimaging may show diffuse white matter lesions, basal ganglia lacunas and rarely a single infarct in a strategic area responsible for contralateral hemiparkinsonism. This clinicoradiological description is currently criticized because it encompasses numerous causes (often non-vascular), explaining the vagueness of this nosological entity.