Background: Recent studies have reported that peripheral neuropathy (PN) is common in patients with Parkinsonâ��s\ndisease (PD) and raised the possibility that levodopa neurotoxicity is the main culprit.\nMethods: We evaluated the presence of large & small (autonomic) fiber PN in 54 consecutive patients with PD or\nparkinsonism in a tertiary outpatient clinic from Brazil. Initial PN screening consisted of history/neurological exam\nand skin wrinkling test (SWT). In addition, we also performed Nerve conduction studies/Electromyography (NCS/EMG)\nin all patients with PN signs/symptoms and/or abnormal SWT.\nResults: Thirty eight patients with PD (10 women, mean age: 63 �± 2.1 years, P < 0.05 versus parkinsonism, mean disease\nduration: 8 �± 0.8 years) and 16 patients with other forms of parkinsonism [7 women, mean age: 50.1 �± 3.9 years, mean\ndisease duration: 6.9 �± 1.1 years] completed clinical neuromuscular evaluation. SWT was performed in 48 patients\n(33 PD, 15 parkinsonism). In the PD group, SWT was abnormal in 57.6 % of the tested patients (comprising 50 %\nof all PD patients). In the parkinsonism group, SWT was abnormal in 37.5 % (comprising 35.3 % of all parkinsonism\npatients). NCS/EMG was performed in 39 patients (26 PD and 13 parkinsonism). Twelve out of the 26 PD (34.2 % of\nall PD) and 4 out of the 13 parkinsonism (23.5 % of all parkinsonism) had abnormal NCS/EMG results. Neuropathy\nprevalence was similar in PD and parkinsonism groups as detected either by NCS/EMG or SWT.\nConclusions: Large fiber and small (autonomic) fiber PN are common in patients with PD and parkinsonism.\nThe etiology for the neuropathy was likely to be multifactorial and may be secondary to PD itself.\nKeywords: Neuromuscular disorders, Parkinsonâ��s disease, Parkinsonism, Skin Wrinkling test, Peripheral neuropathy\nAbbreviations: CMAP, Compound muscle action potential; DM, Diabetes mellitus; EMG, Electromyography; NCS, Nerve\nconduction studies; PD, Parkinsonâ��s disease; PN, Peripheral neuropathy; SFN, Small fiber neuropathy; SNAP, Sensory nerve\naction potential; SWT, Skin winkling test
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