Diagnosing Parkinson Related Diseases

Early in the disease process it may be difficult to distinguish between Parkinson’s disease and Parkinson-like diseases. Frequently the correct diagnosis can only be made after further symptoms develop and the physician is able to monitor the course of the disease. The development of additional symptoms and the subsequent course of the disease generally points to the correct diagnosis.

Parkinsonism caused by a disease other than PD should be considered particularly in patients with:

  • Poor response to dopamine
  • Early loss of balance or vision problems
  • Prominent intellectual decline – dementia
  • Rapid onset or progression
  • Rapid drop in blood pressure after standing up resulting in dizziness or passing out
  • Urinary and bowel incontinence

Parkinsonism Diseases

There is no cure or known cause for the following Parkinson-like diseases except for genetic causes identified in a small fraction of cases.

Supranuclear Palsy (PSP)

PSP is an uncommon progressive neurological disease and form of Parkinsonism. Symptoms usually begin after age 60 and can progress more rapidly than PD. Symptoms may include:

  • balance difficulties
  • sudden falls
  • stiffness
  • an impaired ability to perform certain voluntary eye movements
  • visual disturbances

Individuals may experience slurred speech, swallowing difficulties and personality changes. Dementia often develops during the course of the disease. Parkinson’s medications are often tried but rarely provide benefit. Speech and physical therapy are important for the management of PSP. Learn more about PSP.

Multiple System Atrophy (MSA)

MSA is a collective term for several rare disorders in which multiple systems in the nervous system deteriorate. The average age of symptom onset is in the mid-50s. Symptoms may include:

  • lack of coordination
  • poor balance
  • abnormal autonomic function (fainting spells, heart rate fluctuations, problems with bowel and bladder control)
  • Parkinsonism
  • loss of a sense of smell
  • REM sleep behavior disorder

Patients may respond to PD medications, but often the response is limited. Speech and physical therapy are important for the management of MSA. Learn more about MSA.

Lewy Body Disease or Dementia with Lewy Bodies (LBD)

LBD is a relatively common neurodegenerative disorder that results in progressive and fluctuating cognitive changes and functional deterioration. Symptoms usually begin after age 50 and can progress more rapidly than PD. Symptoms include:

  • decline in thinking abilities
  • hallucinations
  • poor attention span and problem-solving skills
  • Parkinsonism
  • loss of a sense of smell
  • REM sleep behavior disorder
  • mood issues
  • sensitivity to certain types of medications

There are no known therapies to stop or slow the progression of LBD. PD medications can be helpful for symptoms of Parkinsonism, but they can also make the hallucinations worse. Some people with LBD respond well to certain medications used to treat Alzheimer’s disease. Read FAQs about LBD.

Corticobasal Degeneration (CBD) or Corticobasal Ganglionic Degeneration

CBD is a rare neurodegenerative disease and form of Parkinsonism. CBD typically begins around age 60 and may progress more rapidly than PD. In addition to Parkinsonism, symptoms can include:

  • muscle contractions in or loss of control of the limbs
  • difficulties performing simple motor tasks
  • disturbances of language
  • mood issues
  • decline in thinking abilities

Movement symptoms in CBD may be much more prominent on one side of the body. There are no known therapies to stop or slow the progression of CBD. PD medications are often tried but rarely provide benefit. Supportive treatment such as botulinum toxin injections and speech and physical therapy may be helpful. Learn more about CBD.

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