All of the following suggest atypical parkinsonism in a suspected case of parkinsons disease except
High-Yield Explanation
In comparison to PD, the atypical parkinsonisms are characterized clinically by early involvement of speech and gait, absence of rest tremor, lack of motor asymmetry, poor or no response to levodopa, and a more aggressive clinical course. In the early stages, they may show a modest benefit from levodopa and can be difficult to distinguish from PD, but the diagnosis becomes clearer with disease evolution. Ref harrison 20th edition page 3122, 3123. Table 427-3