Index
We are talking about a disorder that causes problems with movement.
Parkinsonism is a disease that occurs when a person has symptoms and brain dysfunction commonly associated with Parkinson’s disease, but also has other symptoms related to an additional condition or cause.
A person who has Parkinson’s will also have another disorder that causes additional neurological symptoms, ranging from dementia to the inability to look up and down.
Parkinson’s disease itself refers to the dysfunction and cell death of the portion of the brain that produces dopamine.
Dopamine is a neurotransmitter, a chemical that transmits signals between the brain and nerve cells. It is partially responsible for performing controlled movements in the body.
Symptoms of Parkinsonism
Symptoms associated with pakinsonism can include:
- Muscular stiffness.
- Changes in speech
- Dementia.
A person with parkinsonism generally begins to develop symptoms between the ages of 50 and 80, according to the University of Texas Southwestern Medical Center.
Parkinson’s disease can cause variable and progressive symptoms throughout its course.
Some of the more common symptoms associated with the disease include:
- Difficulty showing facial expressions.
- Muscular stiffness.
- Slow, affected movements.
- Changes in speech
- Trembling, especially of one hand.
A person with Parkinson’s may have some, but not all, of the symptoms listed above. This is because they also have an additional disorder that affects the functioning of the brain.
For example, people with parkinsonism often do not have the hand tremor that affects many people with Parkinson’s disease.
Other symptoms associated with parkinsonism include:
- Dementia.
- Autonomic nervous system problems, such as problems with controlled movements or spasms.
- Early problems with balance.
- Rapid onset and progression of symptoms.
Each underlying cause of parkinsonism, such as Lewy body dementia, also has its own unique set of symptoms.
Causes
Parkinsonism can be caused by Parkinson’s disease and another underlying condition.
Other causes associated with parkinsonism include:
- Corticobasal degeneration : This condition causes dementia and affected movements, usually on one side. A person may also be unable to do controlled muscle movements.
- Lewy body dementia : This condition causes changes in general alertness, as well as visual hallucinations. According to Johns Hopkins Medicine, this condition is the second most common cause of dementia after Alzheimer’s disease.
- Multisystemic atrophy: This condition affects coordination and autonomic dysfunction, including bowel and bladder incontinence.
- Progressive supranuclear palsy: This condition causes dementia, frequent falls backwards and problems moving the eyes up and down in addition to the symptoms of Parkinson’s disease.
The conditions above are the four most common causes of parkinsonism, according to the University of Texas Southwestern Medical Center.
The number of people with these conditions is about a quarter of the number of people who have Parkinson’s disease itself.
There is also another less common condition called vascular parkinsonism. This condition causes multiple small strokes that can affect a person’s balance, walking, and memory.
Parkinsonism is also sometimes the result of taking certain medications. Doctors call this condition drug-induced parkinsonism. Examples of medications that could cause it include:
- Aripiprazol (Abilify).
- Haloperidol (Haldol).
- Metoclopramida (Reglan).
Ideally, if a person has drug-induced parkinsonism, they can slowly reduce the doses of these drugs.
However, that is not always possible, and a person should not stop taking a drug without their doctor’s approval.
How do doctors diagnose parkinsonism?
Imaging tests may be ordered by a doctor to examine the brain.
There is no single test for doctors to diagnose parkinsonism.
A doctor will start by taking a person’s medical history and reviewing their current symptoms. They will request a list of medications to determine if any medications might be causing the symptoms.
A doctor will likely also order a blood test to check for possible underlying causes, such as thyroid or liver problems. A doctor will also order imaging tests to examine the brain and body for other causes, such as a brain tumor.
Doctors can perform a test that tracks the movement of dopamine in the brain. This is known as the DaT-SPECT test.
The test uses radioactive markers designed to track dopamine in the brain. This allows the doctor to observe the release of dopamine in a person’s brain and to identify the areas of the brain that do or do not receive it.
Because parkinsonism does not respond to typical treatments and can have a variety of symptoms, doctors may have a difficult time reaching a quick diagnosis.
Doctors may need time to rule out other conditions and begin making treatment recommendations.
Treatment of parkinsonism
One of the most commonly prescribed medications to treat Parkinson’s disease is levodopa. This drug is related to dopamine and can increase the amount of dopamine available in the brain.
However, people with parkinsonism not only have trouble producing dopamine, they have also damaged or destroyed cells that cannot respond to dopamine. As a result, levodopa may not work as well to reduce your symptoms.
Doctors can find it difficult to treat parkinsonism because the symptoms of the disease do not always respond as well or at all to drugs that increase dopamine.
As a result, treatments for parkinsonism depend on the “most” disease a person has. For example, if a person has corticobasal degeneration and related muscle spasms, a doctor may prescribe antidepressants and botulinum toxin A injections.
Treatments for parkinsonism generally aim to help reduce a person’s symptoms whenever possible to help them maintain their independence.
Doctors often recommend physical and occupational therapy because they can help a person keep their muscles strong and improve balance.
Panorama
The outlook for parkinsonism depends on the type of parkinsonism a person has and how quickly it affects it.
According to the Parkinson’s Disease Clinic and Research Center at the University of California, San Francisco, the survival rate for a person with multisystem atrophy is approximately 6 years from clinical diagnosis.
People with other types of parkinsonism may have a shorter or longer life expectancy.
The onset and progression of parkinsonism symptoms tend to be much faster than that of Parkinson’s disease alone.
However, researchers are working every day to find treatments for Parkinson’s disease and parkinsonism in the hope of improving quality of life and reducing symptoms.
