# Transcranial Sonography in the Examination of Atypical Parkinsonian Syndromes

## TL;DR

This paper discusses the role of transcranial sonography in diagnosing atypical parkinsonian syndromes, highlighting its accessibility and limitations.

## Contribution

The paper provides a critical evaluation of transcranial sonography's utility in diagnosing atypical parkinsonisms.

## Key findings

- Transcranial sonography is accessible and low-cost but not part of diagnostic criteria for atypical parkinsonisms.
- Atypical parkinsonisms often have overlapping symptoms and poor response to levodopa.
- Neuroimaging methods like transcranial sonography are gaining attention despite diagnostic challenges.

## Abstract

Transcranial sonography is one of the methods of examination used in atypical parkinsonian syndromes. The assessment is not indicated in the diagnostic criteria of entities in this group e.g., Progressive Supranuclear Palsy, Corticobasal Degeneration, Multiple System Atrophy and Dementia with Lewy Bodies. Atypical parkinsonisms are a group of diseases affected by diverse pathologies including alpha-synuclein or tau among others. Recently broader attention was brought to less common atypical parkinsonisms as Perry syndrome. Atypical parkinsonisms are related to poor response to levodopa treatment, rapid deterioration and unfavorable prognosis. Additionally, the entities often overlap in terms of clinical manifestation, especially in the early stages. Though atypical parkinsonisms are affected by the lack of possibility of obtaining definite in vivo diagnosis, growing interest is associated to supplementary evaluations including neuroimaging. Among these methods could be mentioned magnetic resonance imaging, positron emission tomography, single photon emission computed tomography and transcranial sonography. Transcranial sonography is associated with high accessibility and low cost. The goal of this paper is to highlight the strengths and weaknesses of transcranial sonography in the examination of atypical parkinsonisms.