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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I was interested to read in the conclusion of the abstract of the report of Jankovic et al¹ that "only 65 (8.1%) of 800 patients initially diagnosed as having Parkinson disease (PD) were later found to have an alternate diagnosis based on multifactorial clinical criteria." This conclusion ignores the "gold standard" neuropathological data in the text suggesting the possibility of a much higher misdiagnosis rate.

Eighteen of the 800 patients had an autopsy, the results of which were available for 13. Three (23%) had multiple system atrophy of parkinsonian predominance, 2 (15%) had progressive supranuclear palsy, and 2 (15%) had other non-PD diagnoses, accounting for 54% of cases with autopsy results. Two further patients (15%) had a dementia with Lewy bodies ("1 with PD and Alzheimer disease," 1 with "dementia with the presence of Lewy bodies"). Although it is not explicitly stated, I presume the remaining 4 (31%) actually had . . . [Full Text of this Article]

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