Understanding Parkinsonism | Parkinson’s Foundation

Parkinsonism: A set of movement symptoms associated with Parkinson’s disease (PD) and other disorders. It is important to understand that parkinsonism describes symptoms rather than a specific disorder.

Symptoms include:

• Slow Movements
• Stiffness
• Walking and balance problems
• Tremor

Parkinsonism is a name for a group of movement symptoms found in several conditions, including Parkinson’s disease. These symptoms include slow movements, stiffness, tremor and problems with walking and balance. Parkinsonism disorders can also involve non-movement symptoms, such as changes in mood and thinking, sleep problems and issues with automatic body functions, like blood pressure.

Types of Parkinsonism

Parkinson’s Disease

• A progressive brain disorder with movement and non- movement symptoms
• Symptoms worsen slowly over time
• Movement symptoms tend to improve with levodopa

Atypical Parkinsonism

• A group of progressive brain disorders with some of the symptoms seen in PD
• Symptoms are often more serious early on and progress quicker
• Movement symptoms improve less or not at all with levodopa

Secondary Parkinsonism

• Conditions that mimic PD but are not always progressive
• Symptoms may improve by treating the underlying cause
• Movement symptoms usually do not improve with levodopa

Atypical Parkinsonism Disorders

Atypical parkinsonism disorders have specific traits that may help set them apart from each other.

Dementia with Lewy Bodies (DLB)

• Progressive short-term memory loss and confusion
• Difficulty focusing or staying alert
• Seeing things that are not there, like shadowy figures in your side vision

Multiple System Atrophy (MSA)

• Lightheadedness when standing up or wide swings in blood pressure
• Difficulty controlling the bladder

Progressive Supranuclear Palsy (PSP)

• Slow or limited eye movements, both upward and downward
• Serious balance problems and frequent falls early on
• Early changes in thinking and behavior
• Slurred or hoarse speech

Corticobasal Degeneration (CBD)

• Muscle tightness and jerking movements
• Abnormal hand and feet postures (called dystonia)
• Trouble with coordination

Diagnosing Parkinsonism

There is no single test for diagnosing parkinsonism disorders. Your neurologist will review your medical history, symptoms and medications, perform a neurological exam and may order brain scans (like an MRI or DaTscan) or a skin biopsy. How your symptoms respond to levodopa can also provide helpful clues.

Since these disorders share similar symptoms, getting the right diagnosis can sometimes be tricky. It is important to work with a neurologist experienced in parkinsonism. Certain neurologists, known as movement disorders specialists, have extra training in this area. For help finding a specialist, contact our Helpline.

Treating Atypical Parkinsonism

Levodopa may not be effective for all types of atypical parkinsonism, but other medications and lifestyle changes may help reduce symptoms. Physical and occupational therapy, regular exercise and speech therapy are key to staying as active and independent as possible.

Look for a neurologist who can help you build a care team tailored to your needs, including rehabilitation specialists and, if necessary, a social worker, psychiatrist, sleep doctor, urologist or other health professionals.

Secondary Parkinsonism

Some types of parkinsonism may improve if the underlying cause is treated. For example, drug-induced parkinsonism, a type of secondary parkinsonism, often improves after stopping the medication. Drugs commonly linked to this include antipsychotics, anti-nausea medications and some blood pressure drugs. Normal pressure hydrocephalus, which causes memory loss and walking issues, can be treated with a tube to drain excess fluid. Treatment for other forms of secondary parkinsonism depends on the specific cause.

Tips for Navigating Parkinsonism

• If unsure about your diagnosis, ask your doctor for clarification. Keep in mind that a specific diagnosis may take time.
• Stay informed. Understanding your treatment options and available resources can help improve quality of life.
• Connect with others with a similar diagnosis to share experiences, coping strategies and resources.
• Focus on what you can control, like exercise, nutrition, sleep and staying engaged in activities and relationships that are important to you.

Resources