Symptomatic Parkinsonism - Movement Disorders

Symptoms of Parkinson's Disease

It is important to separate Parkinson’s disease from other conditions which produce similar symptoms because the treatment required may be totally different.

Parkinson’s disease is generally referred to as idiopathic Parkinson’s because its cause is unknown (idiopathic literally means cause unknown). However, there is a term “symptomatic Parkinsonism” which refers to a group of movement disorders which produce the same signs and symptoms but in these incidences the causes are known (such as a stroke or the effects of continuous drug taking).

It is not easy to diagnose either Parkinson’s disease or Parkinsonism because they are so similar, especially in the early stages.

Generally speaking if a person has the typical symptoms of Parkinson’s disease - such as tremors, rigidity, slowness of movement and postural instability - and they do not respond to medication, another cause other than idiopathic Parkinson’s should be investigated.

Drug Induced Parkinsonism:

There are certain medications, particularly those used in the treatment of psychiatric disorders such as schizophrenia that can cause tremors and balance problems. These so-called neuroleptic drugs can block the release of dopamine in the brain. Calcium channel blockers used to treat high blood pressure or abnormal heartbeat can also produce similar symptoms.

Generally if the drugs can be withdrawn the symptoms will usually disappear over a period of time ­although it could take many months. However for some people, particularly those with serious psychiatric problems who are taking neuroleptic drugs to control their problem, withdrawing the drug could be dangerous. They may have to continue taking the medication and suffer a degree of Parkinsonism.

MPTP, a DIY chemical used by heroin addicts, can lead to Parkinsonism within days. Research has shown that people who take MPTP have lost huge amounts of dopamine from the brain. The damage is permanent, although the symptoms can be controlled by levadopa. Prolonged use of cocaine and ecstasy are also reported to have a similar effect.

Multiple System Atrophy:

This is a degenerative brain condition for which, at present, there is no known cause. It causes slowness of movement, rigidity, poor co-ordination and balance. The symptoms can be helped in the very short term with dopamine agonists and levadopa but in the longer term there is no effective treatment.

Dementia with Lewy Bodies (DLB):

DLB is a degenerative brain disorder producing the symptoms of Parkinsonism. With this comes early dementia, hallucinations, a low attention span and poor problem solving skills. Levodopa can make the hallucinations worse.

Vascular or Arteriosclerotic Parkinsonism:

Sometimes a number of small strokes can cause Parkinsonism, with patients often suffering walking difficulties.

Progressive Supernuclear Palsy:

This degenerative disease causes poor balance leading to frequent falls. Eventually there will be problems with eye movement leaving a person unable to look down or up. The disease progresses far quicker than Parkinson’s and there are no specific medical treatments.

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