Table of ContentsView AllTable of ContentsPotential CausesTypes of ParkinsonismNeurodegenerative DisordersDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Potential Causes
Types of Parkinsonism
Neurodegenerative Disorders
Diagnosis
Treatment
Frequently Asked Questions
Parkinsonism, also known asatypicalor secondary Parkinsonism, is a condition that impacts movement and causes symptoms similar to those seen in Parkinson’s disease. These include muscle stiffness, slow movement, speech impairment, tremors at rest, and more.
Parkinsonism is also called atypical Parkinsonism, secondary Parkinsonism, or Parkinsonism plus.
What Is Parkinson’s?
Verywell / Katie Kerpel
There are several possible causes of Parkinsonism, but most people withParkinson’s symptomswill be diagnosed with Parkinson’s disease, which is called idiopathic Parkinson’s (idiopathic means “unknown cause”).
Is Parkinson’s Disease Inherited?
Parkinson’s Disease
However, about 15% of people who have these symptoms will be diagnosed with secondary Parkinsonism instead of Parkinson’s disease.
Parkinsonism occurs when a person has a condition that mimics the symptoms of Parkinson’s disease, but unlike Parkinson’s disease, the cause can be identified.
What Are the Stages of Parkinson’s Disease?
Medications
The most common type of Parkinsonism is drug-induced Parkinsonism. Some antipsychotic and antidepressant medications that alter dopamine production in the brain have Parkinsonism as a side effect.
Viruses
Other Causes
There are also other possible causes of Parkinsonism, including:
Symptoms of Parkinsonism
The symptoms of Parkinsonism are the same as the symptoms ofParkinson’s disease. The three defining symptoms of Parkinsonism are bradykinesia, rigidity, and tremors.Many would add a fourth—postural instability.
Bradykinesiais a term that health professionals use to describe the slow movement that is characteristic of Parkinsonism (“brady” means slow, and “kinesia” means movement).
Someone with bradykinesia moves very slowly. For example, it might take them a long time to bring a fork to their mouth or put on a shirt.
They also will have a slower reaction time. If you ask them to perform an action, such as passing you a napkin, they will only do so after a delay—it might appear that they have not heard you or are ignoring you. They may also speak very slowly and softly.
Bradykinesia
Bradykinesia also affects how a person walks. It produces a very recognizable slow, shuffling gait with very short steps. A person’s feet may get “stuck” during steps—they may freeze, or find it hard to initiate each step.
Health professionals refer to the characteristic slow walk as “Parkinsonian gait.” It is a dangerous symptom because it can lead to falls.
Tremors
Tremors are one of theearlier symptoms of Parkinsonism and Parkinson’s disease. There are many types of tremors, but the tremors that occur in Parkinsonism are calledresting tremors, meaning that they happen when a person is at rest and not performing a voluntary action.
These tremors typically occur in the hands and arms, but sometimes occur in the chin or legs. The restinghand tremorsare sometimes referred to as “pill-rolling” because it looks like the person is repeatedly rolling a pill between their thumb and fingers.
Causes of Resting Tremors in Parkinson’s Disease
Rigidity
The third defining symptom of Parkinsonism is musclerigidity. The muscles are stiff and resist movement. They also can experience pain and soreness in their muscles. This can cause a person to have very stiff, rigid movements.
Parkinsonism SymptomsTremor at rest (usually in the hands)Short, shuffling gait (“Parkinsonian gait” pattern)Slow movement“Freezing” during movementSlow, soft speechTrouble sleepingDry skinApathyFace masking(lack of facial expressions)Difficulty with balanceFrequent fallsMicrographia (very small handwriting)Stiff and rigid musclesCogwheeling
Parkinsonism Symptoms
Tremor at rest (usually in the hands)Short, shuffling gait (“Parkinsonian gait” pattern)Slow movement“Freezing” during movementSlow, soft speechTrouble sleepingDry skinApathyFace masking(lack of facial expressions)Difficulty with balanceFrequent fallsMicrographia (very small handwriting)Stiff and rigid musclesCogwheeling
Rigidity in Parkinson’s
Symptoms of Secondary Parkinsonism
Parkinsonism refers to a collection of symptoms, but there are multiple conditions that can cause these symptoms. It may help you to think of these causes asdifferent “types”of Parkinsonism. The diagnosis, treatment, and outcomes depend on the type.
The most common types of atypical Parkinsonism include drug-induced Parkinsonism, neurodegenerative disorders, heredodegenerative conditions, and vascular Parkinsonism.
New Study Says Parkinson’s May Actually Be 2 Diseases
Drug-Induced Parkinsonism
The reasons why it is more common are probably related to the increase ofpolypharmacy(the use of multiple medications at a time) among older populations, as well as an increased life expectancy.
Compared to Parkinson’s disease, drug-induced Parkinsonism is less likely to cause tremors and more likely to cause symmetrical symptoms (the same symptoms on both sides of the body).
Drugs that affect the brain’s dopamine levels or production (dopamine receptor antagonists) are known to have Parkinsonism as a side effect.However, other drugs—including those that are used to treatschizophrenia, high blood pressure, migraines, depression, or another condition—can also cause Parkinsonism.
Several drugs have Parkinsonism as a possible side effect.These include:
Stopping these medications may not immediately make Parkinsonism symptoms go away.It can take weeks—sometimes up to a year—for the symptoms of Parkinsonism to remit after a person stops taking the medication that caused it. Symptoms can persist indefinitely for some people.
Your doctor will help you figure out the best course of action, whether it be altering your medications, weaning off your medication, and/or treating your Parkinsonism symptoms.
Neurodegenerative disorders can also lead to Parkinsonism symptoms.Neurodegeneration is the progressive loss of neurons (nerve cells).
Conditions associated with Parkinsonism symptoms include:
PSP is the most common type of degenerative Parkinsonism. CBD is the least common.
Heredodegenerative Conditions
Heredodegenerative conditions also cause the loss of neurological functioning but are genetically inherited conditions rather than acquired conditions. Several heredodegenerative conditions have been found to cause Parkinsonism.Note that sometimes Parkinson’s disease is inherited.
Heredodegenerative conditions associated with Parkinsonism include:
How Are Parkinson’s Dementia and Dementia with Lewy Bodies Different?
Vascular Parkinsonism
Vascular Parkinsonism (VP) is the cause of 2.5% to 5% of all cases of Parkinsonism.
People with VP display more lower-body symptoms, primarily a wide stance and gait impairment. As their symptoms progress, they may experience urinary incontinence and a decline in cognition.
Studies have found that people with VP develop white matter lesions and lacunes in the brain that are distinct from the brain changes in Parkinson’s disease.
VP is sometimes referred to as arteriosclerotic Parkinsonism, vascular pseudo-Parkinsonism, or lower-body Parkinsonism.
Differential diagnosis(the process of testing and ruling out all possible conditions) is important when someone presents with Parkinsonism to help prevent misdiagnosis.
Your doctor needs to find the correct underlying cause of a patient’s Parkinsonism, because the treatments for drug-induced Parkinsonism, vascular Parkinsonism, Parkinson’s disease, dementia with Lewy bodies, and other causes differ.
If you see your doctor for Parkinsonism, they might refer you to a general neurologist or a movement disorder specialist.
MisdiagnosisResearch has shown that up to 25% of diagnoses might be incorrect because movement disorder specialists have a high degree of clinical accuracy when diagnosing Parkinsonism syndromes, whereas general neurologists tend to over-diagnose Parkinson’s disease and under-diagnose secondary Parkinsonism.The clinical management of these conditions, however, typically use the same medications.
Misdiagnosis
Research has shown that up to 25% of diagnoses might be incorrect because movement disorder specialists have a high degree of clinical accuracy when diagnosing Parkinsonism syndromes, whereas general neurologists tend to over-diagnose Parkinson’s disease and under-diagnose secondary Parkinsonism.The clinical management of these conditions, however, typically use the same medications.
During the diagnosis process, your doctor will evaluate your symptoms and medical history. They may use brain imaging tests such asmagnetic resonance imaging(MRI) orcomputed tomography(CT).
In some cases, your doctor may also want you to try takinglevodopa—a drug that is used to treat Parkinson’s disease—to see if it helps your symptoms.
Parkinsonism symptoms can lead to falls and impair your ability to function in everyday life. To address these issues, your doctor might suggest occupational, physical, and speech therapy. While these rehabilitation professionals won’t cure your Parkinsonism symptoms, they can help increase your independence and safety.
A speech therapist can help you improve your communication and speech, develop nonverbal strategies to communicate, and learn techniques to help your memory.
Without dopamine, a person will experience the symptoms of bradykinesia, rigidity, and tremors that are characteristic of Parkinsonism.
The exact cause of the damage to dopamine-producing cells is unknown and likely differs from person to person.
What is the difference between Parkinson’s disease and Parkinsonism?
Parkinson’s disease is a neurodegenerative disorder that leads to movement symptoms and non-movement symptoms. It is sometimes called idiopathic (unknown cause), but the cause is believed to be a combination of genetic and environmental factors.
Parkinsonism is a more general term that encompasses the symptoms of Parkinson’s disease. A variety of disorders or syndromes can lead to Parkinsonism, and these syndromes can lead to faster progression of symptoms, increased falling, presence of hallucinations, and can be non-responsive to levodopa (the drug that is used to treat Parkinson’s disease).
Which age group is Parkinsonism more prevalent in?
There is more data on the incidence of Parkinson’s disease than there is for Parkinsonism. The incidence of Parkinson’s disease increases with age, and the diagnosis is more likely in older populations.
About 4% of people with Parkinson’s disease will be diagnosed before they turn 50 years old.
Do Only Older People Get Parkinson’s?
Summary
Older adults who are taking multiple medications (particularly antipsychotic medications that affect dopamine levels) need to be screened for drug-induced Parkinsonism, which is the most common cause of the symptoms.
Receiving an accurate diagnosis is essential to forming a helpful treatment plan. Parkinsonism is typically seen as “harder” to treat than Parkinson’s disease, which might be because it is initially misdiagnosed as Parkinson’s disease and does not respond to levodopa treatment.
Your treatment may include stopping, changing, or adding medications, such as levodopa. You may also receive outpatient or in-home therapy from rehabilitation professionals, such as occupational, physical, and speech therapists, to help you regain your independence and stay safe.
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13 Sources
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Parkinson’s Foundation.Types of parkinsonisms.
Limphaibool N, Iwanowski P, Holstad MJV, et al.Infectious etiologies of parkinsonism: pathomechanisms and clinical implications.Front Neurol. 2019;10. doi:10.3389/fneur.2019.00652
Racette B, Criswell S, Lundin J, et al.Increased risk of parkinsonism associated with welding exposure.NeuroToxicology. 2012;33(5):1356-1361. doi:10.1016/j.neuro.2012.08.011
Keener AM, Bordelon YM.Parkinsonism.Semin Neurol. 2016;36(4):330-334. doi:10.1055/s-0036-1585097
Stamelou M, Hoeglinger GU.Atypical parkinsonism: an update.Curr Opin Neurol. 2013;26(4):401-405. doi:10.1097/WCO.0b013e3283632da6
Nature.Neurodegeneration.
Gupta D, Kuruvilla A.Vascular parkinsonism: what makes it different?Postgraduate Med J. 2011;87(1034):829-836. doi:10.1136/postgradmedj-2011-130051
Korczyn AD.Vascular parkinsonism—characteristics, pathogenesis and treatment.Nature Reviews Neurology. 2015;11(6):319-326. doi:10.1038/nrneurol.2015.61
Levin J, Kurz A, Arzberger T, et al.The differential diagnosis and treatment of atypical parkinsonism.Dtsch Arztebl Int. 2016;113(5):61-69. doi:10.3238/arztebl.2016.0061
Parkinson’s Foundation.Parkinson’s disease vs. parkinsonism.
Parkinson’s Foundation.Statistics.
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