Secondary parkinsonism
Parkinsonism - secondary; Atypical Parkinson diseaseSecondary parkinsonism is when symptoms similar to Parkinson disease are caused by certain medicines, a different nervous system disorder, or another illness.
Parkinsonism refers to any condition that involves the types of movement problems seen in Parkinson disease. These problems include tremors, slow movement, and stiffness of the arms and legs.
Parkinson disease
Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors...
Read Article Now Book Mark ArticleCauses
Secondary parkinsonism may be caused by health problems, including:
- Brain injury
- Diffuse Lewy body disease (a type of dementia)
Dementia
Dementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...
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Encephalitis
Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
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HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...
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Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
Read Article Now Book Mark Article - Multiple system atrophy
Multiple system atrophy
Multiple system atrophy- parkinsonian type (MSA-P) is a rare condition that causes symptoms similar to Parkinson disease. However, people with MSA-P...
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Progressive supranuclear palsy
Progressive supranuclear palsy (PSP) is a movement disorder that occurs from damage to certain nerve cells in the brain.
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Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Wilson disease
Wilson disease is an inherited disorder in which there is too much copper in the body's tissues. The excess copper damages the liver and nervous sys...
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Other causes of secondary parkinsonism include:
- Brain damage caused by anesthesia medicines (such as during surgery)
- Carbon monoxide poisoning
Carbon monoxide poisoning
Carbon monoxide is an odorless gas that causes thousands of deaths each year in North America. Breathing in carbon monoxide is very dangerous. It i...
Read Article Now Book Mark Article - Certain medicines used to treat mental disorders or nausea (for example, metoclopramide and prochlorperazine)
- Mercury poisoning and other chemical poisonings
- Overdoses of narcotics
- MPTP (a contaminant in some street drugs)
Symptoms
Common symptoms include:
- Decrease in facial expressions
- Difficulty starting and controlling movement
- Loss or weakness of movement (paralysis)
- Soft voice
- Stiffness of the trunk, arms, or legs
- Tremor
Tremor
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...
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Confusion and memory loss may be likely in secondary parkinsonism. This is because many diseases that cause secondary parkinsonism also lead to dementia.
Exams and Tests
Your health care provider will perform a physical exam and ask questions about your medical history and symptoms. Be aware that the symptoms may be hard to assess, particularly in older adults.
Examination may show:
- Difficulty starting or stopping voluntary movements
- Tense muscles
- Problems with posture
- Slow, shuffling walk
- Tremors (shaking)
Reflexes are usually normal.
Tests may be ordered to check for other problems that can cause similar symptoms.
Treatment
If the condition is caused by a medicine, your provider may recommend changing or stopping the medicine.
Treating underlying conditions, such as stroke or infections, can reduce symptoms or prevent the condition from getting worse.
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleIf symptoms make it hard to do everyday activities, your provider may recommend medicine. Medicines used to treat this condition can cause severe side effects. It is important to see your provider for check-ups. Secondary parkinsonism tends to be less responsive to medical therapy than Parkinson disease.
Outlook (Prognosis)
Unlike Parkinson disease, some types of secondary parkinsonism may stabilize or even improve if the underlying cause is treated. Some brain problems, such as Lewy body disease, are not reversible.
Possible Complications
This condition may lead to these problems:
- Difficulty performing daily activities
- Difficulty swallowing or eating
Difficulty swallowing
Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This proble...
Read Article Now Book Mark Article - Disability (differs from person to person)
- Injuries from falls
- Pneumonia from breathing in saliva or from choking on food
- Side effects of medicines
Effects from loss of strength and mobility (debilitation):
- Breathing food, fluid, or mucus into the lungs (aspiration)
Aspiration
Aspiration means to draw in or out using a sucking motion. It has two meanings:Breathing in a foreign object (for example, sucking food into the air...
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Deep vein thrombosis
Deep vein thrombosis (DVT) is a condition that occurs when a blood clot forms in a vein deep inside a part of the body. DVT mainly affects the large...
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Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
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When to Contact a Medical Professional
Contact your provider if:
- Symptoms of secondary parkinsonism develop, come back, or get worse.
- New symptoms appear, including confusion and movements that cannot be controlled.
- You are unable to care for the person at home after treatment starts.
Prevention
Treating conditions that cause secondary parkinsonism may decrease the risk.
People taking medicines that can cause secondary parkinsonism should be carefully monitored by their provider to prevent the condition from developing.
References
Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-1266. PMID: 29570866 pubmed.ncbi.nlm.nih.gov/29570866/.
Jankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.
Ostrem JL, Okun MS. Parkinsonism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 378.
Pringsheim T, Day GS, Smith DB, et al. Guideline Subcommittee of the AAN. Dopaminergic Therapy for Motor Symptoms in Early Parkinson Disease Practice Guideline Summary: A Report of the AAN Guideline Subcommittee. Neurology. 2021 Nov 16;97(20):942-957. PMID: 34782410 pubmed.ncbi.nlm.nih.gov/34782410/.
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
Central nervous system and peripheral nervous system - illustration
The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.
Central nervous system and peripheral nervous system
illustration
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
Review Date: 3/31/2024
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.