Parkinsonism
Parkinsonism is a clinical syndrome characterised by tremor, muscle rigidity, slowness of movement (bradykinesia), and postural instability. It is not a single disease but a group of conditions that share these motor features.
Key takeaways
- The common thread in all forms of parkinsonism is disruption to the brain circuits that regulate smooth, coordinated movement, usually involving reduced dopamine activity in the basal ganglia.
- Symmetry, early falls, eye movements, autonomic symptoms and recent medicine exposure help separate Parkinson’s disease from drug-induced and atypical parkinsonism.
- Treatment depends on the underlying cause.
The listings below do not identify the cause of parkinsonism; levodopa response and the need to change a causative medicine vary by diagnosis.
What causes parkinsonism
Parkinsonism is a pattern, not a final diagnosis. Causes include Parkinson’s disease, other neurodegenerative conditions and medicine effects; the speed of change, symmetry, falls, eye movements and response to treatment help a specialist distinguish them.
Managing symptoms
When medicine-induced parkinsonism is suspected, the responsible treatment is reviewed carefully rather than stopped abruptly. Procyclidine may be considered for selected drug-induced symptoms, but anticholinergic adverse effects can be important, especially in older people. Other causes need a different plan led by neurology.
When to seek urgent care
Seek emergency care for sudden weakness, new difficulty speaking, fainting, a first seizure, abrupt severe headache, new loss of walking ability, or rapidly worsening confusion.