![non tremulous non tremulous](https://assets.cureus.com/uploads/figure/file/65941/lightbox_9e66e710844311e9b2558d74e0c587e9-Figure1.png)
Given that the confirmation of the diagnosis of PD can be only obtained through neuropathology, to improve and facilitate the diagnostic–therapeutic workup in PD, a number of criteria and guidelines have been introduced in the last three decades.
![non tremulous non tremulous](http://vortexmedicine.com/blog/wp-content/uploads/2019/02/Parkinsons-disease-natural-treatment.jpg)
The misdiagnosis is even higher when only the initial diagnosis is considered, since the diagnostic accuracy improves by time, during follow-up visits. The diagnosis of Parkinson’s disease (PD) is based on clinical features and differently to the common opinion that detecting this condition is easy, seminal clinicopathological studies have shown that up one-fourth of patients diagnosed as PD during life has an alternative diagnosis at postmortem. 5Department of Neurology, Santa Maria University Hospital, Terni, Italy.4Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.3IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.2Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, United States.1Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.