Parkinson’s disease and other related conditions

Several neurological conditions may appear to be idiopathic (without known cause) PD at first, but they eventually trace back to known causes, progress differently, and respond differently to therapy. These other conditions include the following:

Essential tremor (ET) is perhaps the most common type of tremor, affecting as many as five million Americans. ET differs from the tremor in idiopathic PD in several ways: ET occurs when the hand is active (as in eating, grasping, writing, and such). It may also occur in the face, voice, and arms. The renowned actress, Katherine Hepburn, had ET, not PD. Differentiating ET from PD is very important because each condition responds to completely different sets of medications.

Parkinson-plus syndromes may initially have the same symptoms as PD. But these syndromes also cause early and severe problems with balance, blood pressure, vision, and cognition and usually have a much faster progression compared to PD.

Secondary parkinsonism can result from head trauma or from damage to the brain due to multiple small strokes (atherosclerotic or vascular parkinsonism). Both forms can be ruled out through scans (CTs or MRIs) that produce images of the brain.

Pseudoparkinsonism can appear to be PD when in fact the person has another condition (such as depression) that can mimic the inexpressive face of PWP.

Drug - or toxin-induced parkinsonism can occur from taking antipsychotic medications (drug-induced) or from exposure to toxins such as carbon monoxide and manganese dust (toxin-induced). Drug-induced symptoms are usually (but not always) reversible; toxin-induced symptoms usually aren’t.

The subtleties of diagnosing idiopathic PD may lead your family doctor to send you to a neurologist, a specialist in the treatment of neurological conditions. If that happens, don’t panic. Getting the correct diagnosis is the first step toward figuring out what comes next for you.

Parkinson’s disease

Parkinson’s — A Movement Disorder

Parkinson’s disease is a disease in a group of conditions called movement disorders — disorders that result from a loss of the brain’s control on voluntary movements. Dopamine (a neurotransmitter in the brain) relays signals from the substantia nigra to those brain regions (putamen, caudate, and globus pallidus — collectively named the basal ganglia — in the striatum) that control movement, balance, and coordination. In the brain of people with Parkinson’s (PWP), cells that produce this essential substance die earlier than normal.

Although a whole group of conditions are known as parkinsonism, the one that most people know is called idiopathic PD, a Greek word that means arising spontaneously from an unknown cause. As the term suggests, the jury is still out as to the underlying cause (though theories do exist).

Go into a room filled with 50 people with Parkinson’s (PWP) and ask how they first suspected they had PD. You’re likely to hear 50 different stories. Take ten of those people who were diagnosed at approximately the same time and you’re likely to see varying signs of PD progression — from almost no progression to more rapid onset of symptoms. Similarly, you’re likely to experience a variety of attitudes and outlooks from the individuals dealing with their PD.

When you’re diagnosed with PD, you set out on a unique journey — one where your outlook, lifestyle changes, and medical treatment can be key directional maneuvers along the way. In truth, this disease is one that you can live with, surrender to, or fight with everything you’ve got. The road veers and curves differently for each person. Some people may choose one path for managing symptoms, and some people choose another. Sometimes the disease itself sets the course. The bottom line? No clear roadmaps are available. But one fact is certain: Understanding the chronic and progressive nature of PD can take you a long way toward effectively managing your symptoms and living a full life.