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Atypical Parkinsonism — DGM MCQ

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HardMovement disordersAtypical ParkinsonismDGM

A 77-year-old woman has Parkinsonism with falls within the first year and poor response to levodopa. She also has postural instability and mild vertical gaze limitation. Her GP is asked to increase levodopa. Current medicines include co-careldopa. What is the most appropriate referral?

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Correct answer: C — Urgent specialist movement-disorder review

Early falls, poor levodopa response and vertical gaze limitation suggest atypical Parkinsonism such as progressive supranuclear palsy. Routine primary-care management, repeated dose escalation, podiatry-only referral and essential tremor diagnosis miss red flags. Atypical features should prompt specialist review.

Reference: NICE NG71