Written by:
Leonardo Marcelo Abanto-Florez
Edited by:
Andrea Herrera Gorriti
Kevin Duque
You might have come across the word parkinsonism and wondered what it means. It sounds similar to Parkinson’s, so could it just be another name for the disease? Not exactly.
Parkinsonism is a medical term that describes a group of symptoms such as tremor, stiffness, balance problems, and rigidity. This means that different diseases fall under the umbrella of parkinsonism. But what about Parkinson’s itself? Parkinson’s disease is one of them, but it’s not the only one. Other conditions can look very similar, especially in the early stages.
You might now be asking: what exactly do these symptoms mean, and which other diseases are included in parkinsonism? Those are the questions this blog will start to answer.
What is Parkinsonism?
For doctors, parkinsonism is a useful starting point to figure out which underlying condition is causing the symptoms and how best to treat or manage it.
To define parkinsonism, there must be slowness of movement (bradykinesia) together with either tremor, rigidity, or balance problems (or sometimes all of them).
The main signs of parkinsonism are:
- Slowness of movement (bradykinesia): People often describe this as feeling like their body is moving in slow motion. Everyday tasks such as making the bed, brushing your teeth, or walking across a room can take longer and feel more difficult than they used to.
- Stiffness (rigidity): Your muscles may feel tight or rigid, even without pain. This can make it harder to swing your arms when walking or to turn your chest smoothly.
- Tremor: Not everyone with parkinsonism has a tremor, but when it does occur, it often starts in one hand while at rest. It can look like the person is repeatedly pinching the air with their fingers.
- Balance and posture problems: Patients might lean forward slightly when walking or take short, shuffling steps. As the condition progresses, it becomes harder to keep balance or recover from bumps and stumbles, which can reduce quality of life.
Now that we know the main symptoms of parkinsonism and how to recognize them, the next step is to understand the diseases that fall under this term-including Parkinson’s disease. The most common way to divide parkinsonism into typical and atypical forms.
Types of Parkinsonism
Typical parkinsonism
Typical parkinsonism refers to cases that show the classic symptoms without “red flags” or atypical signs. The only condition in this category is Parkinson’s disease (PD).
PD is the most common form of parkinsonism worldwide. It usually starts around age 60 and is more frequent in men. The onset of PD can be subtle and often progresses gradually, with symptoms usually starting asymmetrically (more on one side of the body). Sometimes, the first signs are non-motor symptoms, such as smaller handwriting, reduced facial expressions, sleep disturbances, depression, or loss of smell.
The classic motor symptoms are tremors, rigidity, and bradykinesia. These might not always be obvious to the patient but can be detected during a neurological exam.
If you want to learn more about Parkinson’s disease, visit our blog on Parkinson’s
Atypical Parkinsonism
Atypical parkinsonism refers to a group of conditions were, in addition to the classic symptoms, patients may also show:
- Eye movement abnormalities → Trouble moving the eyes normally (for example, difficulty looking up or down).
- Early cognitive or psychiatric changes → Early changes in memory, thinking, or mood (such as depression, anxiety, or confusion).
- Other movement disorders (dystonia, myoclonus, chorea) → Other unusual movements, like painful muscle contractions, sudden jerks, or involuntary twisting movements.
- Voice and speech abnormalities → Changes in the voice or speech (such as a weak, broken, or hoarse voice, or strange noises while breathing).
- Difficulty swallowing (dysphagia) → Problems swallowing food or liquids.
- Falls occurring early in the disease
- Rapid disease progression
- Spasticity → tightness that changes with speed, often sudden and jerky (like pulling on a rubber band that suddenly snaps)
Examples of atypical parkinsonism include:
- Multiple system atrophy (MSA)
- Progressive supranuclear palsy (PSP)
- Corticobasal syndrome (CBS)
- Dementia with Lewy bodies (DLB)
- Drug-induced Parkinsonism
- Normal pressure hydrocephalus (NPH)
- Chronic alcohol-related brain damage
We’ll talk more about each of these conditions in future blogs.
Why seeing a specialist matter
To find out what’s really going on, you need to see a neurologist, who can ask detailed questions about when the symptoms started, how they have changed, and what other signs are present. With time, testing, and ability, doctors can put the pieces together to make the right diagnosis.
At the CCBP study, we are developing a better biomolecular classification of these conditions. Our goal is to understand them more deeply and to move closer to creating personalized treatments for each individual.
Reference
- Bologna, M., Truong, D., & Jankovic, J. (2022). The etiopathogenetic and pathophysiological spectrum of parkinsonism. Journal of the Neurological Sciences, 433, 120012. https://doi.org/10.1016/j.jns.2021.120012
- Respondek, G., Stamelou, M., & Höglinger, G. U. (2019). Chapter Two – Classification of atypical parkinsonism per pathology versus phenotype. In International Review of Neurobiology (Vol. 149, pp. 37-47). Elsevier. https://doi.org/10.1016/bs.irn.2019.10.003
- Levin, J., Kurz, A., Arzberger, T., Giese, A., & Höglinger, G. U. (2016). The differential diagnosis and treatment of atypical Parkinsonism. Deutsches Ärzteblatt International, 113(5), 61-69. https://doi.org/10.3238/arztebl.2016.0061
- Hayes, M. T. (2019). Parkinson’s disease and Parkinsonism. The American Journal of Medicine, 132(7), 802–807. https://doi.org/10.1016/j.amjmed.2019.03.001