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Secondary parkinsonism

Parkinsonism - secondary; Atypical Parkinson disease

Secondary 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.

Images

Central nervous system and peripheral nervous system

Causes

Secondary parkinsonism may be caused by health problems, including:

Other causes of secondary parkinsonism include:

There have been rare cases of secondary parkinsonism among IV drug users who injected a substance called MPTP, which can be produced when making a form of heroin.

Symptoms

Common symptoms include:

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

The health care provider will perform a physical exam and ask questions about the person's medical history and symptoms. Be aware that the symptoms may be hard to assess, particularly in older adults.

Examination may show:

Reflexes are usually normal.

Tests may be ordered to confirm or rule out other problems that can cause similar symptoms.

Treatment

If the condition is caused by a medicine, the 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.

If symptoms make it hard to do everyday activities, the provider may recommend medicine. Medicines used to treat this condition can cause severe side effects. It is important to see the 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:

Side effects from loss of strength (debilitation):

When to Contact a Medical Professional

Call the provider if:

Prevention

Treating conditions that cause secondary parkinsonism may decrease the risk.

People taking medicines that can cause secondary parkinsonism should be carefully monitored by the provider to prevent the condition from developing.

Related Information

Parkinson disease
Stroke
Encephalitis
Meningitis
Toxins
Hemoglobin derivatives
Aspiration
Deep vein thrombosis

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 www.ncbi.nlm.nih.gov/pubmed/29570866/.

Jankovic J. Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 96.

Okun MS, Lang AE. Parkinsonism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 381.

Tate J. Parkinson disease. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier 2020: 721-725.

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Review Date: 2/4/2020  

Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Stony Brook University School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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