What is 'Parkinsonism'?

World Parkinson’s Day is marked on 11 April each year, and while the clever ‘Shake It Up’ campaign being used to raise funds for a Parkinson’s cure may be raising a few eyebrows, it’s a closely related disease that is often overlooked.

It’s called ‘Parkinsonism’ and it occurs when someone has symptoms and brain dysfunctions associated with Parkinson’s coupled with another disorder causing neurological symptoms such as dementia or the inability to look up or down.

Parkinson’s is caused by the death of brain cells that produces dopamine – a chemical transmitter that sends signals between the brain and nerve cells responsible for controlling movement. When a person has Parkinson’s, it can be clearly defined by significantly affected movements, such as constant shaking, difficulty holding items or walking.

Parkinsonism symptoms may include extreme muscle stiffness, speech impediments and dementia. The disease usually occurs to people aged between 50 and 80.

Someone with Parkinson’s disease may have difficulty controlling or even showing facial expressions, muscle stiffness, slowed movements, speech changes and tremors, mainly in one hand.

Parkinsonism may include some, but not all, of these symptoms along with an additional disorder that affects the brain function. Often a person with Parkinsonism will not have the hand tremor, but may have dementia, problems with balance, nervous system issues, and will experience a more rapid onset and progression of these symptoms.

The disease is caused by Parkinson’s itself, but can also be brought on by other conditions such as corticobasal degeneration (affected movements on one side), dementia with Lewy bodies (changes in levels of alertness and visual hallucinations), multiple system atrophy (affecting coordination of bowel and bladder) and progressive supranuclear palsy (frequent falls, problems moving eyes and eventually, dementia).

Another condition called vascular Parkinsonism causes multiple small strokes and can affect balance, memory and movement.

Parkinsonism can also be caused by certain medications, such as aripiprazole (Abilify), haloperidol (Haldol), and metoclopramide (Reglan). Symptoms can be mitigated by reducing dosage of these medicines, but only with a doctor’s approval.

Diagnosis of Parkinsonism is tricky – there is no single test. Doctors will start by reviewing a patient’s health history and current symptoms, then will order blood tests to check for underlying causes, such as thyroid or liver problems, or any medicines that may be causing the symptom. They’ll also order imaging scans and tests to check the brain for movement of dopamine, tumours or other causes.

Doctors can have difficulty coming to a quick diagnosis, first having to rule out other conditions and before recommending treatment.

Treatment may involve a medication called levodopa, which increases the amount of dopamine in the brain and is also used to treat Parkinson’s disease. But as Parkinsonism damages and even destroys brain cells which then cannot respond to dopamine, this may not work.

That’s when doctors will turn to treating the additional condition by prescribing medication for one of the four other causes. They will also recommend physical and occupational therapy to strengthen muscles and improve balance. The idea is to mitigate symptoms to help the patient live as independently as possible.

The outlook for those with Parkinsonism varies with the severity and progression of symptoms, but the onset and progression does tend to be much faster than Parkinson’s alone.

However, researchers are working to find treatments in the hope of extending and improving the lives of those with the disease.

Read more at www.medicalnewstoday.com

Have you ever heard of Parkinsonism? Do you know of anyone who has this disease?

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