Table of ContentsView AllTable of ContentsIdiopathic Parkinson’s DiseaseEarly-Onset Parkinson’sFamilial Parkinson’sSecondary ParkinsonismAtypical ParkinsonismAssociated ConditionsFrequently Asked QuestionsNext in Parkinson’s Disease GuideWhat Are the Stages of Parkinson’s Disease?
Table of ContentsView All
View All
Table of Contents
Idiopathic Parkinson’s Disease
Early-Onset Parkinson’s
Familial Parkinson’s
Secondary Parkinsonism
Atypical Parkinsonism
Associated Conditions
Frequently Asked Questions
Next in Parkinson’s Disease Guide
This article will review the different types of Parkinson’s disease, including the causes of secondary parkinsonism and atypical parkinsonism.
Verywell / Katie Kerpel
Idiopathic (the cause is unknown) Parkinson’s disease is the most common type of PD. It affects older individuals, with an average age of onset around 60.
The symptoms of idiopathic PD are divided into two categories—motor (movement) and non-motor.
Motor symptoms of PD include:
Motor symptoms tend to start out mild and worsen slowly over time. They also begin on one side of the body and eventually spread to the other side.
Advanced PDIn the laterstagesof PD, motor symptoms become so severe that medication stops working well.Difficulties with walking, speaking, and swallowing also become prominent.
Advanced PD
In the laterstagesof PD, motor symptoms become so severe that medication stops working well.Difficulties with walking, speaking, and swallowing also become prominent.
Non-motor symptoms of PD can develop before a diagnosis of PD is even suspected.
Non-motor symptoms include:
Symptoms of Parkinson’s Disease
Early-onset PD, also known as youth-onset PD, is a rare type of PD that affects individuals between the age of 21 and 40 or 50 years (studies use varying age cut-offs).
Symptoms of early-onset PD are similar to idiopathic PD, but they tend to progress more slowly.Regardless, since people are in the prime of their life when diagnosed, symptoms tend to have a more drastic psychological and social impact.
A distinguishing feature of early-onset PD is that side effects related tolevodopa(a drug used to treat the condition) likedyskinesia(uncontrollable body movements) and thewearing-off phenomenon(in which the drug becomes less effective) tend to occur earlier compared to idiopathic PD.
In order to try to delay these undesirable side effects, doctors initially treat patients with early-onset PD with dopamine agonists or monoamine oxidase inhibitors. These are alternative drugs to levodopa.
Parkinson’s Disease Treatment
Scientists have discovered several genes linked to PD and uncovered how mutations within these genes influence risk and disease development. As an example, mutations in the gene SNCA are linked toautosomal dominantParkinson’s disease.
Autosomal DominantAn autosomal dominant pattern of inheritance means that you only need one copy of a gene to be mutated for the disease to manifest.
Autosomal Dominant
An autosomal dominant pattern of inheritance means that you only need one copy of a gene to be mutated for the disease to manifest.
With secondary parkinsonism, a person may develop one or more of the same movement-related symptoms as those seen in Parkinson’s disease.
Unlike Parkinson’s disease, secondary parkinsonism occurs as a result of an underlying process or factor, such as a drug, head trauma, toxins, brain infection, or stroke. All of these causes block or interfere with dopamine levels or function in the brain.
Drug-Induced Parkinsonism
Drug-induced parkinsonism (DIP) is the most common type of secondary parkinsonism. It occurs when symptoms of PD develop after taking a medication, most commonly an antipsychotic drug.
The motor symptoms of drug-induced parkinsonism mimic those in idiopathic PD, except they tend to occur equally on both sides of the body.
Vascular Parkinsonism
Vascular parkinsonism, also called arteriosclerotic parkinsonism, is a form of secondary parkinsonism in which motor symptoms seen in PD develop fromsmall vessel (lacunar) strokesin the substantia nigra or the basal ganglia (two areas of the brain).
Astrokeoccurs when a blood vessel that supplies the brain is blocked or bleeds into the brain. Without adequate blood flow, brain cells die, and various symptoms manifest depending on the area of the brain affected.
The diagnosis of a stroke can be confirmed with amagnetic resonance imaging (MRI)test of the brain. Smoking cessation and controlling risk factors likehigh cholesterolorhigh blood pressure (hypertension)can help prevent strokes.
Arterial Disease Types: Risk Factors, Causes, and Symptoms
“Atypical parkinsonism” is an umbrella term for neurodegenerative diseases that share similar symptoms of PD, including:
Distinguishing PD from these parkinsonian diseases can be challenging, particularly in the early stages of the disease.
Dementia with Lewy Bodies
Other possible symptoms of DLB include:
Patients with DLB also commonly experience parkinsonism (symptoms such as tremors, slowness, and stiffness), although they are not essential for diagnosis. Parkinsonianism should develop within a year of the dementia to be DLB. While dementia develops in Parkinson’s disease, it usually takes 10 to 30 years.
Multiple System Atrophy (MSA)
Multiple system atrophy (MSA)is a rare neurodegenerative disease that results from the loss of nerve cells involved in regulating movement and theautonomic nervous system.
Autonomic Nervous SystemYour autonomic nervous system is the component of your nervous system that controls involuntary processes like blood pressure and digestion.
Autonomic Nervous System
Your autonomic nervous system is the component of your nervous system that controls involuntary processes like blood pressure and digestion.
Symptoms of MSA tend to develop in a person’s 50s and progress rapidly over a period of five to 10 years.
MSA symptoms are highly variable and may include:
Progressive Supranuclear Palsy (PSP)
Progressive supranuclear palsy (PSP), also known as Steele-Richardson-Olszewski syndrome, is an uncommon parkinsonian syndrome.
Its onset, like idiopathic PD, is in late middle age; however, the symptoms of PSP worsen more rapidly than PD.
The symptoms of PSP are highly variable but commonly include problems with walking and balance resulting in falls, as well as difficulty controlling eye movements.
Other symptoms of PSA may include:
Corticobasal Syndrome
Corticobasal syndrome (CBS) is a rare neurodegenerative disease that develops at an average age of 64 and causes changes in movement.Language and cognitive problems may also occur.
Like PSP and Alzheimer’s disease, in CBS, abnormal levels of the protein tau collect in brain cells, eventually leading to the death of those cells.
Most commonly, the motor symptoms of CBS affect one side of the body, such as stiffness of one arm, leg, or both.
Other motor symptoms of CBS include:
Conditions Associated With Parkinson’s
Some neurological conditions mimic and/or are related to or linked to Parkinson’s disease.
Essential Tremor
Essential tremor (ET)causes rhythmic shaking of both hands and arms. It may also involve the head, trunk, voice, and rarely, the legs. ET often runs in families and is a disorder that slowly worsens over time.
That said, patients with PD often have an action tremor prior to developing more obvious PD signs. Experts aren’t sure if this action tremor is ET or an early sign of PD.
Relationship Between ET and PDSeveral other interesting, although still poorly understood, links have been found between ET and PD.
Relationship Between ET and PD
Several other interesting, although still poorly understood, links have been found between ET and PD.
Normal Pressure Hydrocephalus
Normal pressure hydrocephalus (NPH)is a neurological disease of older adults that develops when cerebrospinal fluid (CSF) builds up in thebrain’s ventricles, or cavities.
The classic symptoms of NPH are:
Parkinsonian motor symptoms, with the exception of resting tremor, also frequently occur among people living with NPH. This can make differentiating between the two diseases tricky.
A careful examination of symptom characteristics and timeline can be helpful. Motor symptoms in PD are asymmetric early on in the disease (typically symmetric in NPH), anddementia in PDdoes not occur until the later stages.
What Is Parkinson’s Disease?
Summary
A Word From Verywell
If you think you or your loved one may be experiencing symptoms of PD like stiff muscles, shaking, or slower walking, please reach out to your primary care physician or a movement disorder specialist.
While these symptoms may be from PD, they could also be attributed to another condition. A thorough evaluation will help you obtain the right diagnosis so you can move forward with a proper treatment plan.
Parkinson’s disease is not reversible with the exception of drug-induced parkinsonism. This is a type of secondary parkinsonism that arises from taking a medication that blocks or interferes with dopamine in the brain.
Most people with Parkinson’s disease have no family history of the disease. Only 10%–15% of cases of PD are believed to be inherited.
Parkinson’s disease is not typically inherited and causes stiffness, tremor, and slowed movements.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pagano G, Ferrara N, Brooks DJ, Pavese N.Age at onset and Parkinson disease phenotype.Neurology.2016;86(15):140–07. doi:10.1212/WNL.0000000000002461Luquin M-R, Kulisevsky J, Martinez-Martin P, Mir P, Tolosa ES.Consensus on the definition of advanced Parkinson’s disease: A neurologists-based Delphi study (CEPA Study).Parkinsons Dis.2017;2017:4047392. doi:10.1155/2017/4047392Schapira AHV, Chaudhuri KR, Jenner P.Non-motor features of Parkinson disease.Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.62Camerucci E, Stang CD, Hajeb M et al.Early-onset parkinsonism and early-onset Parkinson’s disease: A population-based study (2010-2015).J Parkinsons Dis.2021;11(3):1197-1207. doi:10.3233/JPD-202464Parkinson’s Foundation.Genetics and Parkinson’s.Sung YH, Noh Y, Lee J, Kim EY.Drug-induced parkinsonism versus idiopathic Parkinson disease: Utility of nigrosome 1 with 3-T imaging.Radiology. 2016;279(3):849-58. doi:10.1148/radiol.2015151466Outeiro TF, Koss DJ, Erskine D et al.Dementia with Lewy bodies: an update and outlook.Mol Neurodegener. 2019;14(1):5. doi:10.1186/s13024-019-0306-8National Institute of Neurological Disorders and Stroke.Multiple system atrophy fact sheet.National Institute of Neurological Disorders and Stroke.Progressive supranuclear palsy information page.Rowe JB, Holland N, Rittman T.Progressive supranuclear palsy: diagnosis and management.Pract Neurol.2021;21(5):376-383. doi:10.1136/practneurol-2020-002794Constantinides VC, Paraskevas GP, Paraskevas PG, Stefanis L, Kapaki E.Corticobasal degeneration and corticobasal syndrome: A review.Clin Park Relat Disord. 2019;1:66-71. doi:10.1016/j.prdoa.2019.08.005National Organization for Rare Disorders.Apraxia.Graff-Radford J, Rubin MN, Jones DT et al.The alien limb phenomenon.J Neurol. 2013;260(7):1880-88. doi:10.1007/s00415-013-6898-yTarakad A, Jankovic J.Essential tremor and Parkinson’s disease: Exploring the relationship.Tremor Other Hyperkinet Mov (N Y). 2018;8:589. doi:10.7916/D8MD0GVRMolde K, Söderström L, Laurell K.Parkinsonian symptoms in normal pressure hydrocephalus: a population-based study.J Neurol. 2017;264(10):2141–2148. doi:10.1007/s00415-017-8598-5
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pagano G, Ferrara N, Brooks DJ, Pavese N.Age at onset and Parkinson disease phenotype.Neurology.2016;86(15):140–07. doi:10.1212/WNL.0000000000002461Luquin M-R, Kulisevsky J, Martinez-Martin P, Mir P, Tolosa ES.Consensus on the definition of advanced Parkinson’s disease: A neurologists-based Delphi study (CEPA Study).Parkinsons Dis.2017;2017:4047392. doi:10.1155/2017/4047392Schapira AHV, Chaudhuri KR, Jenner P.Non-motor features of Parkinson disease.Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.62Camerucci E, Stang CD, Hajeb M et al.Early-onset parkinsonism and early-onset Parkinson’s disease: A population-based study (2010-2015).J Parkinsons Dis.2021;11(3):1197-1207. doi:10.3233/JPD-202464Parkinson’s Foundation.Genetics and Parkinson’s.Sung YH, Noh Y, Lee J, Kim EY.Drug-induced parkinsonism versus idiopathic Parkinson disease: Utility of nigrosome 1 with 3-T imaging.Radiology. 2016;279(3):849-58. doi:10.1148/radiol.2015151466Outeiro TF, Koss DJ, Erskine D et al.Dementia with Lewy bodies: an update and outlook.Mol Neurodegener. 2019;14(1):5. doi:10.1186/s13024-019-0306-8National Institute of Neurological Disorders and Stroke.Multiple system atrophy fact sheet.National Institute of Neurological Disorders and Stroke.Progressive supranuclear palsy information page.Rowe JB, Holland N, Rittman T.Progressive supranuclear palsy: diagnosis and management.Pract Neurol.2021;21(5):376-383. doi:10.1136/practneurol-2020-002794Constantinides VC, Paraskevas GP, Paraskevas PG, Stefanis L, Kapaki E.Corticobasal degeneration and corticobasal syndrome: A review.Clin Park Relat Disord. 2019;1:66-71. doi:10.1016/j.prdoa.2019.08.005National Organization for Rare Disorders.Apraxia.Graff-Radford J, Rubin MN, Jones DT et al.The alien limb phenomenon.J Neurol. 2013;260(7):1880-88. doi:10.1007/s00415-013-6898-yTarakad A, Jankovic J.Essential tremor and Parkinson’s disease: Exploring the relationship.Tremor Other Hyperkinet Mov (N Y). 2018;8:589. doi:10.7916/D8MD0GVRMolde K, Söderström L, Laurell K.Parkinsonian symptoms in normal pressure hydrocephalus: a population-based study.J Neurol. 2017;264(10):2141–2148. doi:10.1007/s00415-017-8598-5
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pagano G, Ferrara N, Brooks DJ, Pavese N.Age at onset and Parkinson disease phenotype.Neurology.2016;86(15):140–07. doi:10.1212/WNL.0000000000002461Luquin M-R, Kulisevsky J, Martinez-Martin P, Mir P, Tolosa ES.Consensus on the definition of advanced Parkinson’s disease: A neurologists-based Delphi study (CEPA Study).Parkinsons Dis.2017;2017:4047392. doi:10.1155/2017/4047392Schapira AHV, Chaudhuri KR, Jenner P.Non-motor features of Parkinson disease.Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.62Camerucci E, Stang CD, Hajeb M et al.Early-onset parkinsonism and early-onset Parkinson’s disease: A population-based study (2010-2015).J Parkinsons Dis.2021;11(3):1197-1207. doi:10.3233/JPD-202464Parkinson’s Foundation.Genetics and Parkinson’s.Sung YH, Noh Y, Lee J, Kim EY.Drug-induced parkinsonism versus idiopathic Parkinson disease: Utility of nigrosome 1 with 3-T imaging.Radiology. 2016;279(3):849-58. doi:10.1148/radiol.2015151466Outeiro TF, Koss DJ, Erskine D et al.Dementia with Lewy bodies: an update and outlook.Mol Neurodegener. 2019;14(1):5. doi:10.1186/s13024-019-0306-8National Institute of Neurological Disorders and Stroke.Multiple system atrophy fact sheet.National Institute of Neurological Disorders and Stroke.Progressive supranuclear palsy information page.Rowe JB, Holland N, Rittman T.Progressive supranuclear palsy: diagnosis and management.Pract Neurol.2021;21(5):376-383. doi:10.1136/practneurol-2020-002794Constantinides VC, Paraskevas GP, Paraskevas PG, Stefanis L, Kapaki E.Corticobasal degeneration and corticobasal syndrome: A review.Clin Park Relat Disord. 2019;1:66-71. doi:10.1016/j.prdoa.2019.08.005National Organization for Rare Disorders.Apraxia.Graff-Radford J, Rubin MN, Jones DT et al.The alien limb phenomenon.J Neurol. 2013;260(7):1880-88. doi:10.1007/s00415-013-6898-yTarakad A, Jankovic J.Essential tremor and Parkinson’s disease: Exploring the relationship.Tremor Other Hyperkinet Mov (N Y). 2018;8:589. doi:10.7916/D8MD0GVRMolde K, Söderström L, Laurell K.Parkinsonian symptoms in normal pressure hydrocephalus: a population-based study.J Neurol. 2017;264(10):2141–2148. doi:10.1007/s00415-017-8598-5
Pagano G, Ferrara N, Brooks DJ, Pavese N.Age at onset and Parkinson disease phenotype.Neurology.2016;86(15):140–07. doi:10.1212/WNL.0000000000002461
Luquin M-R, Kulisevsky J, Martinez-Martin P, Mir P, Tolosa ES.Consensus on the definition of advanced Parkinson’s disease: A neurologists-based Delphi study (CEPA Study).Parkinsons Dis.2017;2017:4047392. doi:10.1155/2017/4047392
Schapira AHV, Chaudhuri KR, Jenner P.Non-motor features of Parkinson disease.Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.62
Camerucci E, Stang CD, Hajeb M et al.Early-onset parkinsonism and early-onset Parkinson’s disease: A population-based study (2010-2015).J Parkinsons Dis.2021;11(3):1197-1207. doi:10.3233/JPD-202464
Parkinson’s Foundation.Genetics and Parkinson’s.
Sung YH, Noh Y, Lee J, Kim EY.Drug-induced parkinsonism versus idiopathic Parkinson disease: Utility of nigrosome 1 with 3-T imaging.Radiology. 2016;279(3):849-58. doi:10.1148/radiol.2015151466
Outeiro TF, Koss DJ, Erskine D et al.Dementia with Lewy bodies: an update and outlook.Mol Neurodegener. 2019;14(1):5. doi:10.1186/s13024-019-0306-8
National Institute of Neurological Disorders and Stroke.Multiple system atrophy fact sheet.
National Institute of Neurological Disorders and Stroke.Progressive supranuclear palsy information page.
Rowe JB, Holland N, Rittman T.Progressive supranuclear palsy: diagnosis and management.Pract Neurol.2021;21(5):376-383. doi:10.1136/practneurol-2020-002794
Constantinides VC, Paraskevas GP, Paraskevas PG, Stefanis L, Kapaki E.Corticobasal degeneration and corticobasal syndrome: A review.Clin Park Relat Disord. 2019;1:66-71. doi:10.1016/j.prdoa.2019.08.005
National Organization for Rare Disorders.Apraxia.
Graff-Radford J, Rubin MN, Jones DT et al.The alien limb phenomenon.J Neurol. 2013;260(7):1880-88. doi:10.1007/s00415-013-6898-y
Tarakad A, Jankovic J.Essential tremor and Parkinson’s disease: Exploring the relationship.Tremor Other Hyperkinet Mov (N Y). 2018;8:589. doi:10.7916/D8MD0GVR
Molde K, Söderström L, Laurell K.Parkinsonian symptoms in normal pressure hydrocephalus: a population-based study.J Neurol. 2017;264(10):2141–2148. doi:10.1007/s00415-017-8598-5
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