. 2012 Nov 20;260(9):2212–2219. doi: 10.1007/s00415-012-6736-7

Table 3.

Queen Square Brain Bank clinical diagnostic criteria for the diagnosis of Parkinson’s disease

Step 1. Diagnosis of parkinsonian syndrome

Bradikinesia (slowness of initiation of voluntary movement with progressive reduction in speed and amplitude or repetitive actions)

And at least one of the following:

Muscular rigidity

4–6 Hz rest tremor

Postural instability not caused by primary visual, vestibular, cerebellar, or proprioceptive dysfunction

Step 2. Exclusion criteria for Parkinson’s disease

History of repeated strokes with stepwise progression of parkinsonian features

History of repeated head injury

History of definite encephalitis

Oculogyric crises

Neuroleptic treatment at onset of symptoms

More than one affected relative

Sustained remission

Strictly unilateral features after 3 years

Supranuclear gaze palsy

Cerebellar signs

Early severe autonomic involvement

Early severe dementia with disturbances of memory, language, and praxis

Babinski signs

Presence of a cerebral tumor or communicating hydrocephalus on CT scan

Negative response to large doses of l-dopa (if malabsorption excluded)

MPTP exposure

Step 3. Supportive prospective positive criteria of Parkinson’s disease. Three or more required for diagnosis of definite Parkinson’s disease:

Unilateral onset

Rest tremor present

Progressive disorder

Persistent asymmetry affecting the side of onset most

Excellent response (70–100 %) to l-dopa

Severe l-dopa-induced chorea

l-dopa response for 5 years or more

Clinical course of 10 years or more

Hyposmia

Visual hallucination