Parkinson’s disease is a form of Parkinsonism .Parkinsonism is a more general term used to describe a set of symptoms that typically associate with Parkinson’s disease but sometimes stem from other causes.
The main signs include:
- Tremor
- Rigidity
- Slow motion
- Balance problems.
The difference between Parkinson’s disease and Parkinsonism is important, as some of these other reasons can be treated while others do not respond to treatment or medication.
Not all parkinsonian patients suffer from Parkinson’s disease. 85% of cases of Parkinsonism are due to Parkinson’s disease. Some medicines, vascular problems and other neurodegenerative diseases can cause symptoms similar to Parkinson’s disease . In fact, at the beginning of the disease process, it can be difficult to see if the patient has a typical Parkinson’s disease or a mimicking syndrome. The development of additional symptoms and the further course of the disease usually point to the correct diagnosis .
Other causes of parkinsonism , besides Parkinson’s disease, include:
- Side Effects of Prescription Drugs
- Drug use
- Exposure to environmental toxins
- Stroke
- Thyroid and parathyroid gland disorders
- Recurrent head trauma (for example, a trauma associated with boxing and a multitude of brain congestions)
- Brain tumor
- Excessive fluid around the brain (hydrocephalus)
- Inflammation of the brain (encephalitis) as a result of infection
Other neurological diseases, including Alzheimer’s disease, Lewy’s disease, Creutzfeldt - Jakob disease, Wilson’s disease and Huntington’s disease.
4.1. Drug-induced Parkinsonism
That which results from Side effects of drugs , like those that affect dopamine levels in the brain , such as antipsychotics or antidepressants, can cause parkinsonian symptoms .
Although tremors and postural instability may be less severe, it may be difficult to distinguish this condition from Parkinson’s disease.
Drugs that can lead to parkinsonism include antipsychotics, metoclopramide, reserpine, tetrabenazine, some calcium channel blockers, stimulants such as amphetamines and cocaine. Usually, after stopping these drugs, parkinsonism gradually disappears for weeks to months.
4.2. Progressive supranuclear palsy
Progressive supranuclear palsy is one of the most common forms of atypical parkinsonism .
Symptoms of the condition usually begin after the age of 50 and progress more rapidly than Parkinson’s disease. These include imbalance and frequent falls at the onset of the illness, rigidity of the trunk, changes with voice and swallowing, and problems with eye movements, including the ability to move the eyes up and down. Dementia develops later.
There are no laboratory or imaging studies for progressive supranuclear palsy.
There is no specific treatment for progressive supranuclear palsy. Therapies such as speech therapy, kinesitherapy and antidepressants are essential in the treatment of the disease.
4.3. Corticobasal degeneration
Corticobasal degeneration is the least common atypical cause of parkinsonism .
Corticobasal degeneration develops after 60 years of age and progresses more rapidly than Parkinson’s disease.
The initial symptoms of corticobasal degeneration include asymmetric bradykinesia, rigidity, dystonia and limb myoclonus, postural instability and speech disorders. Disabling apraxia of the affected limb is also often found when difficulty or inability to perform coordinated movements of the affected limb occurs, although there is no weakness or loss of sensitivity.
There are no laboratory or imaging studies of the brain to confirm the diagnosis of corticobasal degeneration. Diagnosis is clinical.
There is no specific treatment . Maintenance treatments, such as botulinum toxin for dystonia, antidepressants, speech and physical therapy, can be helpful. Levodopa and dopamine agonists (medicines shown in Parkinson’s disease) rarely help.
4.4. Multiple systemic atrophy
Multiple systemic atrophy is a term for several diseases where one or more systems in the body get worse.
The multiple systemic atrophy category includes Shay-Dregger syndrome, striatalgonal degeneration and olivopontocerebellar atrophy.
The average age of onset of the condition is in the fifth decade of life. Symptoms include bradykinesia, impaired balance, abnormal autonomic function, rigidity, coordination difficulties, or a combination of these signs.
Initially, it may be difficult to distinguish multiple systemic atrophy from Parkinson’s disease, although faster progression, poor response to drugs used in Parkinson’s disease, and the development of other symptoms in addition to parkinsonism may be key to differentiation diagnosis.
There are no laboratory or imaging studies of the brain to confirm the diagnosis of multiple systemic atrophy.
Patients are slightly affected by the drugs shown in Parkinson’s disease.
4.5. Vascular Parkinsonism
Multiple micro-injectors can cause parkinsonism .
Patients with this disease are more likely to manifest with gait difficulties than tremors, and tend to exhibit symptoms that are worse in the lower part of the body.
Some patients have a history of sudden onset of symptoms, while others have a history of worsening of the condition.
Vascular parkinsonism is static (or very slowly progressive) compared to other neurodegenerative diseases.
4.6. Dementia with Levi’s Bodies
Lewy body dementia is a neurodegenerative disease that leads to progressive intellectual and functional deterioration.
Patients with Lewy body dementia usually have early dementia, visual hallucinations, fluctuations in cognitive status during the day, and parkinsonism. It is not unusual for patients to experience cognitive problems, especially speech disorders known as aphasia.
There are no known therapies for halting or slowing the progression of dementia with Lewy bodies.
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