I was recently diagnosed with parkinsonism. What causes it, and how can I cope as it progresses?
Answer From Joseph Y. Matsumoto, M.D.
Parkinsonism is any condition that causes a combination of the movement abnormalities seen in Parkinson's disease — such as tremor, slow movement, impaired speech or muscle stiffness — especially resulting from the loss of dopamine-containing nerve cells (neurons).
Not everyone who has parkinsonism has Parkinson's disease. There are many other causes of parkinsonism (secondary parkinsonism), including:
- Medications, such as those used to treat psychosis, major psychiatric disorders and nausea
- Repeated head trauma, such as injuries sustained in boxing
- Certain neurodegenerative disorders, such as multiple system atrophy, Lewy body dementia and progressive supranuclear palsy
- Exposure to toxins, such as carbon monoxide, cyanide and organic solvents
- Certain brain lesions, such as tumors, or fluid buildup
- Metabolic and other disorders, such as chronic liver failure or Wilson's disease
Managing parkinsonism with medications
- For drug-induced parkinsonism, discontinuing the medications that cause the condition may reverse it.
For other forms of parkinsonism, taking Parkinson's disease medications — typically a carbidopa-levodopa combination drug (Sinemet, Duopa, Stalevo) — can help.
However, these drugs aren't likely to be as effective for some forms of parkinsonism as they are for Parkinson's disease. Levodopa — which occurs naturally in the body and is always taken as a combination drug — replenishes brain dopamine, and brain dopamine loss is fundamental to Parkinson's disease. However, in other parkinsonian disorders, additional brain pathways may be affected.
Other steps you can take
Certain lifestyle changes also may help you cope with parkinsonism:
- Stay physically active. To the extent you're able, try to sustain your normal daily activities, exercise regularly, and incorporate physical and occupational therapy as needed.
- Create a safe environment. If gait and balance become impaired, consider modifying your environment. For example, install grab bars next to your toilet or in your shower; remove obstacles, such as throw rugs; and keep frequently used items within reach.
Joseph Y. Matsumoto, M.D.
Aug. 10, 2017
- Chou KL. Diagnosis and differential diagnosis of Parkinson disease. https://www.uptodate.com/contents/search. Accessed June 23, 2017.
- Parkinson disease. Merck Manual Professional Version. https://www.merckmanuals.com/professional/neurologic-disorders/movement-and-cerebellar-disorders/secondary-and-atypical-parkinsonism. Accessed June 30, 2017.
- Goldman L, et al., eds. Parkinsonism. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed July 1, 2017.
- Daroff RB, et al. Parkinson disease and other movement disorders. In: Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed July 6, 2017.
- Halter JB, et al. Parkinson disease and related disorders. In: Hazzard's Geriatric Medicine and Gerontology. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.mhmedical.com. Accessed July 6, 2017.
- Safety at home. National Parkinson Foundation. http://www.parkinson.org/Parkinson-s-Disease/Living-Well/Safety-at-Home. Accessed June 30, 2017.
- Matsumoto JY (expert opinion). Mayo Clinic, Rochester, Minn. July 18, 2017.