Although more than half of the dopaminerigc neurons at the subtantia nigra (SN) have already degenerated when the first motor syp-toms of Parkinson's disease (PD) occur, it is - especially in the beginning of the disease -sometimes difficult to differentiate between idiopathic PD and atypical Parkinsonian syndromes (PS) or idiopathic PD (iPD) and secondary PS.
In recent years, transcranial sonography (TCS) has become a valuable tool in the differential diganosis of Parkinsonian syndromes, especially in the early course of the disease. Moreover, recent data indicates that TCS may even be helpful for the preclinical identification of people at risk for PD.
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