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Many of us are familiar with Parkinson’s disease, but the term parkinsonism may not be as familiar. Parkinsonism is a term for a group of neurological conditions that cause difficulty with
movement. Some of the defining symptoms of parkinsonism include: * slowness of movement * tremors * rigid muscles * trouble walking * impaired posture Parkinson’s disease is the most common
type of parkinsonism. It makes up about 80 percent of parkinsonism cases. Other types of parkinsonism are collectively known as atypical parkinsonian disorders or Parkinson-plus syndromes.
There are many types of parkinsonism that closely mimic symptoms of Parkinson’s, and diagnosis can be difficult. In this article, we look at the different types of parkinsonism and break
down the symptoms and treatment of each. How parkinsonism differs from Parkinson’s disease Parkinson’s disease is one of many types of parkinsonism. It’s caused by a loss of cells in the
part of your brain that produces the neurotransmitter dopamine. Parkinson’s disease and the different types of parkinsonism progress in different ways. Some may progress more rapidly than
Parkinson’s disease. Others, like secondary parkinsonism, may be reversible. The conditions also respond differently to treatments. For instance, someone who has a type of parkinsonism may
not respond to the drug levodopa, which is commonly used for Parkinson’s disease. It can be hard to tell the difference between types of parkinsonism. Here’s a look at some of the identified
categories of parkinsonism with their typical symptoms and treatments. Atypical parkinsonism Atypical parkinsonism refers to any type of parkinsonism that isn’t Parkinson’s disease. Types
of atypical parkinsonism include: MULTIPLE SYSTEM ATROPHY Multiple system atrophy is a rare and progressive disease that’s characterized by abnormal deposits of protein in the nervous
system. The cause is unknown, and it affects about 15,000 to 50,000 Americans. SYMPTOMS The initial symptoms are similar to those of Parkinson’s disease, but they tend to progress more
quickly. They include: * slowness of movement * tremor * rigidity * croaking or quivering voice * fainting or light-headedness * bladder control problems TREATMENT There’s currently no
treatment for multiple system atrophy that’s known to delay the progression of the disease. Treatment involves targeting individual symptoms. PROGRESSIVE SUPRANUCLEAR PALSY Progressive
supranuclear palsy is a disorder caused by damage to parts of the brain controlling the cranial nerves. Symptoms vary between people, but the first sign is often loss of balance while
walking. This condition also progresses faster than Parkinson’s disease. SYMPTOMS Other signs include: * abrupt and unexplained falls * may fall backward * stiff and awkward gait * slow
movement * blurred vision and problems controlling eyes * alterations in mood * slurred speech * difficulty swallowing TREATMENT There’s no effective treatment for progressive supranuclear
palsy, and it usually doesn’t respond to medication. Treatment revolves around targeting individual symptoms. CORTICOBASAL SYNDROME Corticobasal syndrome is a progressive neurological
disorder that leads to the deterioration of certain areas of your brain. The initial sign is often trouble moving one limb. Eventually, this movement difficulty spreads to all limbs. The
onset of this syndrome is usually between ages 50 to 70. It affects roughly 5 in 100,000 people. SYMPTOMS Symptoms vary greatly but may include: * progressive stiffness of muscles *
inability to make voluntary movements * tremor * brief muscle spasms * speech and language problems * involuntary muscle contractions TREATMENT No treatment has been found to slow the
progression of corticobasal syndrome. Parkinson’s drugs are generally ineffective but may help manage stiffness in some people. DEMENTIA WITH LEWY BODIES Dementia with Lewy bodies is a
disease that leads to deposits of alpha-synuclein proteins in the brain. These proteins are also called Lewy bodies. Abnormal build-up of these chemicals can cause movement, behavior, mood,
and cognitive changes. More than 1 million people in the United States have Lewy body dementia. It most often occurs in adults over 50 and can progress for 2 to 20 years from its onset to
death. SYMPTOMS Movement symptoms include: * muscle stiffness * shuffling walk * tremors * trouble balancing * stooped posture * poor coordination * difficulty swallowing Cognitive symptoms
can include: * hallucinations * unpredictable alertness, attention, and wakefulness * loss of thinking abilities * memory problems * changes in mood and behavior * poor judgment * confusion
Secondary parkinsonism Secondary parkinsonism is when a medical condition or medication leads to symptoms that resemble Parkinson’s. The most common cause of secondary parkinsonism is a side
effect of medications, also known as pseudoparkinsonism. DRUGS THAT CAUSE PARKINSONISM Some drugs can interfere with dopamine transmission in your brain and cause symptoms resembling
Parkinson’s. Drugs that are known to induce parkinsonism include: * neuroleptics (antipsychotics) * dopamine depleting drugs * antiemetics * calcium-channel blockers * mood stabilizers *
antidepressants * antiepileptic drugs Treatment usually involves lowering the dose or ceasing use of the offending medication. CONDITIONS THAT CAUSE PARKINSONISM A number of underlying
conditions can potentially lead to brain damage that causes parkinsonism. Some conditions include: * brain tumors * meningitis * stroke * drug overdose * mercury poisoning * carbon monoxide
poisoning * HIV and AIDS Treatment for parkinsonism caused by an underlying condition involves targeting the root cause and treating the symptoms. Vascular parkinsonism It’s thought that
multiple small strokes in the part of your brain that controls movement can lead to a condition called vascular parkinsonism. Vascular parkinsonism is characterized by parkinsonism symptoms
primarily in the lower limbs and an unsteady gait in the absence of tremors. SYMPTOMS Symptoms include: * shuffling gait * balance problems * primarily lower body symptoms * postural
instability TREATMENT Vascular parkinsonism is typically poorly responsive to the medication levodopa. Treatment primarily focuses on treating symptoms. Physical therapy and lifestyle
changes to improve cardiovascular health are often recommended. Infantile parkinsonism-dystonia Infantile parkinsonism-dystonia is a rare disorder that’s also known as dopamine transporter
deficiency syndrome. It causes a progressive decline in involuntary muscle contractions and other symptoms that resemble those of Parkinson’s disease. It usually begins in infants. There’s
no cure for infantile parkinsonism-dystonia, and it’s caused by a mutation of the gene _SLC6A3._ SYMPTOMS Symptoms of infantile parkinsonism-dystonia include: * involuntary and long-lasting
muscle contractions and cramps * difficult with daily activities * impairments with speaking, eating, drinking, walking, and picking up objects * tremors * slow movements * muscle stiffness
* impaired balance and coordination Other symptoms can be present, like: * abnormal eye movement * reduced facial expressions * irritability * trouble sleeping * digestive problems *
recurrent pneumonia TREATMENT Treatment involves targeting individual symptoms to increase quality of life. Medications to control involuntary muscular contractions and physical therapy are
also commonly used. Juvenile parkinsonism Juvenile parkinsonism develops before the age of 21. Juvenile parkinsonism that responds to the medication levodopa is most often caused by
mutations in the genes _PARK-Parkin_, _PARK-PINK1_, or _PARK-DJ1_. SYMPTOMS The symptoms of juvenile parkinsonism are the same as late-onset parkinsonism, but the onset is at a younger age.
TREATMENT The medication levodopa is the most common treatment. But other supportive therapies may also be used, like botulinum toxin for treating involuntary spasms, as well as deep brain
stimulation and physical therapy. Diagnosis of parkinsonism disorders No single test can diagnose parkinsonism disorders. Doctors use a combination of tests to rule out other possible
conditions and make a diagnosis based on your symptoms and medical history. DIAGNOSIS Parkinsonism can be difficult to diagnose due to the many symptoms that mimic Parkinson’s disease. Here
are ways that some forms of parkinsonism can be diagnosed: * GENETIC TESTING. A genetic test may help identify genes linked to parkinsonism in people with a family history. * DATSCAN. A
DaTscan is a type of imaging technique that lets your doctor see the levels of dopamine in your brain. Low levels may be a sign of Parkinson’s disease. * IMAGING. CT or MRI scans may reveal
damaged blood vessels that suggest vascular parkinsonism. An MRI can also rule out brain tumors or hydrocephalus. * BLOOD TESTS. A blood test may be able to identify proteins that indicate
that you may have a certain type of parkinsonism, like corticobasal degeneration. Possible causes of parkinsonism For many types of parkinsonism, the exact cause isn’t known. Genetic and
environmental factors are both believed to play a role. Parkinson’s disease has been linked to exposure to pesticides and herbicides, as well as living close to industrial plants. Some genes
are also associated with an elevated risk of developing Parkinson’s. Conditions that cause brain damage, like traumatic injuries, tumors, and exposure to certain toxins, are also
potentially contributing factors to the development of parkinsonism. Outlook The outlook of parkinsonism is highly variable depending on factors like the age of onset, the underlying cause,
and your overall health. For example, late-onset Parkinson’s disease tends to progress faster and cause earlier cognitive dysfunction than early-onset Parkinson’s. Parkinsonisms are
progressive conditions that get worse over time. Initiating treatment shortly after symptoms begin can help increase life expectancy and improve quality of life. For Parkinson’s, the primary
treatment is the medication levodopa. Treatment varies for other types of parkinsonism, but primarily involves managing symptoms.