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Introduction
Parkinsonism is an umbrella term that refers to conditions with similar, movement-related effects. These conditions involve slowed movements, and other symptoms are possible depending on the condition. These conditions are usually lifelong, and most (but not all) involve deterioration of your brain. However, most are also treatable
What is the difference between parkinsonism and Parkinson’s disease?
Parkinsonism refers to several conditions — including Parkinson’s disease — that have similar symptoms and features. However, Parkinson’s disease makes up about 80% of all cases of parkinsonism, making it the most common form by far. Other conditions that fall under the term parkinsonism include multiple system atrophy or corticobasal degeneration.
Another key difference is that parkinsonism can happen for reasons that are treatable or even curable. Some of the causes of parkinsonism can also go away on their own and only need treatment for some of their symptoms.
Who does it affect?
Parkinsonism overall is usually an age-related disease. It’s slightly more common in people assigned male at birth than in those assigned female at birth. The most common forms of parkinsonism are more likely to happen after age 60.
But some forms can happen at a much earlier age. The average age when juvenile parkinsonism starts is 17. That form of parkinsonism is also four times more common in assigned males than assigned females.
How common is parkinsonism?
The most common form of parkinsonism, Parkinson’s disease, ranks second among the most common age-related degenerative brain diseases (behind Alzheimer’s disease). It’s also the most common motor (movement-related) brain disease. Experts estimate that it affects at least 1% of people over age 60 worldwide.
How does this condition affect my body?
The effects of parkinsonism depend on why it happens. Most parkinsonian conditions affect parts of your brain responsible for movement. That means you move more slowly. You also may have muscle tremors, causing you to shake.
Symptoms and Causes
What are the symptoms of parkinsonism?
The key symptoms of parkinsonism are:
Slowed movements (bradykinesia)*
Tremors.
Stiffness or rigidity.
*This symptom always happens with parkinsonism.
Other possible symptoms include:
Unstable posture or walking gait.
Flexed, hunched or stooped posture.
Freezing (being unable to move when trying to walk).
Parkinson’s disease
Under normal circumstances, your brain uses chemicals known as neurotransmitters to control how your brain cells (neurons) communicate with each other. When you have Parkinson’s disease, you don’t have enough dopamine, one of the most important neurotransmitters.
When your brain sends activation signals that tell your muscles to move, it fine-tunes your movements. The neurons that fine-tune your movements need dopamine. Without it, they can't do their job correctly. That’s why lack of dopamine causes the slowed movements and tremors symptoms of Parkinson's disease.
With lack of dopamine, the basal ganglia (a key area of your brain) start to deteriorate. As they do, you lose the abilities they once controlled. As Parkinson's disease gets worse, the symptoms expand and intensify. Later stages of the disease often affect how your brain functions, causing dementia-like symptoms and depression.
Genetic Parkinson’s disease
The only confirmed causes of Parkinson's disease are genetic mutations that you inherit from your parents. Genetic Parkinson's disease accounts for about 10% of all cases.
Idiopathic Parkinson’s disease
When Parkinson’s disease isn’t genetic, experts classify it as “idiopathic” (this term comes from Greek and means “a disease of its own”). That means they don’t know exactly why it happens.
Experts suspect Parkinson’s disease happens because of a problem with how your body uses a certain protein, α-synuclein (alpha sy-nu-clee-in). Proteins are chemical molecules that have a very specific shape. When some proteins don’t have the correct shape — a problem known as protein misfolding — your body can’t use them and can't break them down.
With nowhere to go, the proteins build up in various places or in certain cells, like the dopamine-using cells that control movement. Tangles of these proteins are visible when looking at these cells under a microscope.
How is parkinsonism diagnosed ?
Diagnosing parkinsonism relies heavily on a healthcare provider examining your symptoms, asking you questions and reviewing your medical history.
If providers can’t find a specific cause of parkinsonism, they’ll likely try to start treatment soon. If you don’t respond to treatment, providers will likely want to run lab tests. Not responding to Parkinson’s disease treatments may indicate that you have another form of parkinsonism.
What tests will be done to diagnose this condition?
When healthcare providers suspect a condition that falls under parkinsonism, various imaging and diagnostic tests are possible. These include:
Blood tests (these can help look for other forms of parkinsonism).
Computerized tomography (CT) scan.
Genetic testing.
Magnetic resonance imaging (MRI).
Positron emission tomography (PET) scan.
How is parkinsonism treated?
The treatments for parkinsonism depend on the condition itself and what caused it. Most forms of parkinsonism are treatable, and some can stop entirely (though this might not be a cure so much as it is the condition going into remission).
Some examples of treatable conditions include:
Drug-induced parkinsonism. This is usually the easiest type of parkinsonism to treat. It happens when other medications interfere with how your body uses dopamine. Stopping the medication that caused your parkinsonism — often by switching to another medication — is often all it takes to stop this condition. However, it can sometimes take weeks or even months for the symptoms to disappear fully. In rare cases, it may be permanent.
Normal pressure-hydrocephalus. Treating NPH involves relieving the pressure inside your skull. Placing a shunt can help, as the shunt acts as a pressure relief valve so excess CSF can drain out of your skull. This usually reduces or completely stops parkinsonism-type symptoms as long as the shunt works as it should.
Parkinson’s disease. This condition isn't curable but is usually very treatable thanks to the medication levodopa and the medications often combined with it. However, the downside to levodopa is that it loses effectiveness over time and increasing the dose past a certain point increases the chance of having side effects. However, many medications help delay this problem when used instead of or combined with levodopa.
Wilson’s disease. This inherited condition causes too much copper to build up in your body. Treatments that remove excess copper from your body can help prevent this condition from causing permanent damage.
In general, your healthcare provider is the best person to provide more information about whether or not your condition is treatable or curable. That's because so many different conditions fall under parkinsonism, many of which are very different from person to person. Your provider can tell you more about if your condition is treatable and what your treatment options are with your specific case and circumstances.
How to take care of myself or manage symptoms?
Parkinsonism refers to a wide range of conditions and diseases with similar effects and symptoms. Most of these diseases and conditions are severe and have a high risk of complications when there’s a delay in diagnosing and treating them.
Because many of these conditions are so severe and need diagnosing and treating sooner rather than later, you shouldn't try to self-diagnose or treat parkinsonism. If you think you have a form of parkinsonism, it's important to talk to a healthcare provider as soon as possible. They can help you by determining if you have one of these conditions, or they can refer you to a specialist for diagnosis and treatment.
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