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If you or a loved one is living with Parkinson’s disease, you’ve likely heard the term “parkinsonism.” However, you may not know how it differs from Parkinson’s.
Parkinsonism describes a group of symptoms involving movement that can occur with several neurological conditions, including Parkinson’s disease. Types of parkinsonism other than Parkinson’s are sometimes called “atypical Parkinson’s disease” or “Parkinson’s-plus syndromes.”
Read on to learn the key similarities and differences between Parkinson’s disease and parkinsonism.
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The most common types of parkinsonism can cause slow movement, muscle stiffness, tremor, and problems with walking and balance. Doctors look at a person’s specific symptoms and how they develop to help distinguish among the different types of parkinsonism.
Drug-induced parkinsonism (DIP) is caused by certain medications, including some that block dopamine receptors in the brain. DIP is the second most common type of parkinsonism in older adults, after Parkinson’s disease.
Doctors who prescribe medications that can cause DIP should monitor for signs of parkinsonism and other movement disorders. Examples of medicines that may cause DIP include:
Symptoms of parkinsonism may develop within days to months after starting a medication that can cause DIP.
People with DIP may have milder or no resting tremors compared with people with Parkinson’s disease. An important difference is that Parkinson’s is progressive, while DIP symptoms often improve after the medication is stopped. However, DIP symptoms may sometimes persist or reveal previously undiagnosed Parkinson’s disease.
Progressive supranuclear palsy (PSP) usually begins when people are in their mid- to late 60s. The condition involves the buildup of a protein called tau in parts of the brain.
PSP symptoms usually worsen faster than those of Parkinson’s. Although resting tremor can occur with Parkinson’s, it’s less common in PSP. Symptoms of PSP can include:
Multiple system atrophy (MSA) is a neurological disorder that affects movement and other body functions. MSA affects the autonomic nervous system, which controls automatic functions such as digestion and blood pressure. MSA symptoms include:
Vascular parkinsonism can result from changes in the brain’s blood vessels, such as multiple small strokes. Movement problems that mainly affect the lower body, such as a shuffling gait and unsteadiness, are common.
Tremor is less common in vascular parkinsonism than in Parkinson’s disease.
Dementia with Lewy bodies (DLB) is a common type of dementia in older adults. People with DLB can also experience movement symptoms similar to those of Parkinson’s disease.
DLB can cause problems with thinking, attention, alertness, and memory, as well as visual hallucinations. In DLB, dementia may develop before, at the same time as, or within about one year after movement symptoms begin.
Corticobasal degeneration, the least common type of parkinsonism, usually begins around age 60. Symptoms typically include:
Parkinson’s disease and other forms of parkinsonism differ in causes, features, and prognosis.
Differences in signs and symptoms can help doctors distinguish Parkinson’s disease from other types of parkinsonism.
Some Parkinson’s symptoms affect the ability to move. These are called motor symptoms and include:
Other Parkinson’s symptoms aren’t directly related to movement. These nonmotor symptoms may include:
Parkinson’s symptoms generally develop over years. The rate of progression varies from person to person.
Parkinson’s disease and other types of parkinsonism share some common symptoms, including stiffness, tremor, and slow movement. Other symptoms and how quickly they develop can help doctors determine the cause.
Atypical neurodegenerative forms of parkinsonism tend to progress faster than Parkinson’s disease. People with these conditions may have a more limited response to levodopa, a common Parkinson’s medication. Some people with secondary forms of parkinsonism, such as vascular parkinsonism or DIP, may respond to levodopa.
No single test can definitively distinguish among the different types of parkinsonism. Doctors typically review a person’s medical history, medications, and symptoms and perform a physical and neurological exam. Tests such as MRI, positron emission tomography (PET) scans, or DaTscans may provide additional information or help rule out other conditions.
DIP may be diagnosed when a doctor notices signs of parkinsonism after a person starts taking a medication known to cause these symptoms.
Doctors may use tests such as MRI or PET scans to evaluate possible PSP. Symptoms that can help distinguish PSP from Parkinson’s include:
A doctor may look for several features that can help distinguish MSA from Parkinson’s disease:
Several signs and symptoms can help distinguish vascular parkinsonism from Parkinson’s disease:
Dementia is a key feature of DLB. Visual hallucinations can occur with both DLB and Parkinson’s but are more common in DLB.
A person with corticobasal degeneration may have trouble purposefully moving a limb on one side of the body, despite having enough muscle strength. This problem is called apraxia and can make tasks such as cutting food or zipping a jacket difficult.
Other signs can include brief, involuntary muscle jerks, trouble walking, and balance problems.
Because “parkinsonism” is an umbrella term for several conditions, a neurologist will develop a treatment plan based on the cause and symptoms.
Treatment for DIP often involves stopping or gradually lowering the dose of the drug causing the symptoms. Never stop or change the dose of a prescription medication without talking with the doctor who prescribed it.
DIP symptoms usually improve after the medication causing them is stopped, although it can take up to 18 months for symptoms to resolve. Some symptoms may persist and require follow-up care.
People with PSP often have a limited response to Parkinson’s medications. The following approaches may help manage symptoms and improve safety:
Parkinson’s medications may provide limited or no benefit for some people with MSA. Other treatments can help manage symptoms, such as low blood pressure and bladder problems. Currently, there’s no cure for MSA.
Vascular parkinsonism often doesn’t respond well to Parkinson’s medications such as levodopa. However, a small subgroup of people may improve with levodopa.
Treatment also focuses on lowering the risk of future strokes and may include:
DLB treatment may include levodopa to help manage movement symptoms, although the response can vary.
There’s currently no cure for DLB. A safe home environment, assistive equipment, and other therapies can help make daily activities safer and easier.
Medications may help manage cognitive symptoms. Cholinesterase inhibitors are commonly used, while antipsychotic medications require special caution because some can worsen movement symptoms or cause severe reactions.
Currently, there’s no specific treatment for corticobasal degeneration. Physical therapy, occupational therapy, and speech therapy may help manage symptoms.
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I have a brother with Parkinson’s does that mean I could have it too? I have a bad tremor I have been taking primadone for a long time?
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symptoms getting worse after several years. I now have tremors in both hands
Did swallowing exercises, and clenching fists & thrusting them out to release them to give a second of control. Holding… read more
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