Secondary parkinsonism
Key points
- Secondary parkinsonism is a disorder with symptoms similar to Parkinson's disease, but is caused by medication side-effects, a different neurodegenerative disorder, or another illness.
- Parkinson's disease is one of the most common neurologic disorders of the elderly.
- Initial symptoms may be mild and nonspecific (such as mild tremor, slight feeling that one leg/foot is stiff or dragging).
- The health care provider may be able to diagnose secondary parkinsonism based on the patient's history, symptoms, and physical examination.
Alternative names
Parkinsonism - secondary
Definition
Secondary parkinsonism is a disorder with symptoms similar to Parkinson's disease, but is caused by medication side-effects, a different neurodegenerative disorder, or another illness.
Causes, incidence, and risk factors
Parkinson's disease is one of the most common neurologic disorders of the elderly. The term "parkinsonism" refers to any condition that causes any combination of the types of movement abnormalities seen in Parkinson's disease by damaging or destroying dopamine neurons in a certain area of the brain.
Secondary parkinsonism may be caused by disorders such as a Stroke, encephalitis, or Meningitis. Other neurodegenerative disorders such as progressive supranuclear palsy, corticobasal degeneration, and multiple systems atrophy can also damage the dopamine neurons and produce this condition.
Medications including antipsychotics such as haloperidol, metoclopramide, and phenothiazine medications are another common cause of secondary parkinsonism.
Less frequently, exposure to overdoses of narcotics or brain damage caused by anesthesia agents (such as during surgery); exposure to toxins, and carbon monoxide poisoning can cause secondary parkinsonism if they damage the brain area that contains the dopamine neurons.
There have been clusters of cases among intravenous drug users who injected a substance called MPTP, which is a byproduct of an improper technique for synthesizing a form of synthetic heroin (fentanyl derivative). These cases are rare and have affected primarily long-term drug users.
Secondary parkinsonism caused by medications like antipsychotics is usually reversible. If it is caused by toxins, infections, drug-related brain damage, or certain other disorders it may or may not be reversible.
Symptoms of parkinsonism may include stiffness of the trunk, arms, or legs, a decrease in facial expression, soft voice, tremor, some forms of paralysis, and certain problems with control of movement.
Although cognitive dysfunction is not a major feature of Parkinson's disease, it may be more prominent in secondary parkinsonism as the diseases that cause secondary parkinsonism more commonly also result in Dementia.
Written and revised by
Andrey Nailor, M.D.
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