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Parkinsonism

From Justapedia - Reading time: 10 min

"Parkinson's syndrome" redirects here. Not to be confused with Parkinson's disease.
Parkinsonism
File:Sir William Richard Gowers Parkinson Disease sketch 1886.svg
Causes

Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia (slowed movements), rigidity, and postural instability.[1][2] These are the four motor symptoms found in Parkinson's disease (PD), after which it is named, dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), and many other conditions. This set of symptoms occurs in a wide range of conditions and may have many causes, including neurodegenerative conditions, drugs, toxins, metabolic diseases, and neurological conditions other than PD.[3]

Signs and symptoms[edit | edit source]

Parkinsonism is a clinical syndrome characterized by the four motor symptoms found in Parkinson's disease: tremor, bradykinesia (slowed movements), rigidity, and postural instability.[1][2]

Parkinsonism gait problems can lead to falls and serious physical injuries. Other common symptoms include:

Conditions[edit | edit source]

Parkinsonism occurs in many conditions.

Neurological[edit | edit source]

Neurodegenerative conditions and Parkinson plus syndrome that can cause parkinsonism include:[4]

Drug-induced ("pseudoparkinsonism")[edit | edit source]

About 7% of people with parkinsonism developed symptoms as a result of side effects of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol), and rarely, antidepressants. Yet another drug that can induce parkinsonism is the antihistaminic medication cinnarizine, usually prescribed for motion sickness; this is because besides antagonizing histamine receptors this drug antagonizes the dopamine D2 receptors.[8] The incidence of drug-induced parkinsonism increases with age. Drug-induced parkinsonism tends to remain at its presenting level and does not worsen like Parkinson's disease.[9]

Implicated medications include:

Infectious[edit | edit source]

Toxins[edit | edit source]

Evidence exists of a link between exposure to pesticides and herbicides and PD; a two-fold increase in risk was seen with paraquat or maneb/mancozeb exposure.[15]

Chronic manganese (Mn) exposure has been shown to produce a parkinsonism-like illness characterized by movement abnormalities.[16] This condition is not responsive to typical therapies used in the treatment of PD, suggesting an alternative pathway than the typical dopaminergic loss within the substantia nigra.[16] Manganese may accumulate in the basal ganglia, leading to the abnormal movements.[17] A mutation of the SLC30A10 gene, a manganese efflux transporter necessary for decreasing intracellular Mn, has been linked with the development of this parkinsonism-like disease.[18] The Lewy bodies typical to PD are not seen in Mn-induced parkinsonism.[17]

Agent Orange may be a cause of parkinsonism, although evidence is inconclusive and further research is needed.[19]

Other toxins that have been associated with parkinsonism are:

Vascular[edit | edit source]

Other[edit | edit source]

Society and culture[edit | edit source]

In the United States, the 2021 National Defense Authorization Act (NDAA) added parkinsonism to the list of presumptive conditions associated with Agent Orange exposure, enabling affected service members to receive Veterans Affairs disability benefits.[33] 

References[edit | edit source]

  1. ^ a b c Aminoff MJ, Greenberg DA, Simon RP (2005). "Chapter 7: Movement disorders". Clinical Neurology (6th ed.). Lange: McGraw-Hill Medical. pp. 241–45. ISBN 978-0-07-142360-1.
  2. ^ a b Ogawa T, Fujii S, Kuya K, Kitao SI, Shinohara Y, Ishibashi M, Tanabe Y (September 2018). "Role of neuroimaging on differentiation of Parkinson's disease and its related diseases". Yonago Acta Med (Review). 61 (3): 145–55. doi:10.33160/yam.2018.09.001. PMC 6158357. PMID 30275744. Parkinsonian syndromes are a group of movement disorders characterized by classical motor symptoms such as tremors, bradykinesia, and rigidity. They are most frequently due to primary neurodegenerative disease, resulting in the loss of dopaminergic nerve terminals along the nigrostriatal pathway, similar to idiopathic PD, MSA, PSP, CBD, and DLB.
  3. ^ Christine CW, Aminoff MJ (September 2004). "Clinical differentiation of parkinsonian syndromes: prognostic and therapeutic relevance". The American Journal of Medicine. 117 (6): 412–9. doi:10.1016/j.amjmed.2004.03.032. PMID 15380498.
  4. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag Jankovic J, Lang AE (2004). "Diagnosis and Assessment". In Bradley, Walter George (ed.). Neurology in Clinical Practice: Principles of diagnosis and management. Vol. 1. Taylor & Francis. pp. 295–96. ISBN 9789997625885.
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  33. ^ "VA adds three new Agent Orange presumptions". U. S. Department of Veteran Affairs. September 10, 2021. Retrieved March 2, 2022.

External links[edit | edit source]

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