Conditions that Mimic Parkinson's

Parkinsonism is a term used to describe the collection of signs and symptoms found in Parkinson’s Disease (PD). These include slowness (bradykinesia), stiffness (rigidity), tremor and imbalance (postural instability). Conditions other than PD may have one or more of these symptoms, mimicking Parkinson’s.

Essential Tremor

  • Essential tremor (ET) is common amongst the elderly population, yet may begin at any age.
  • Different from the PD tremor in that it generally affects both hands, often involves head tremor and a shaky quality to the voice.
  • Thought to be a different condition from PD, though some symptoms can overlap.
  • Evidence suggests that those with ET may be at higher risk of developing PD than the general population.
  • The diagnosis of ET is clinical and treatment is generally with medications, though surgery can be used in severe cases.

Normal Pressure Hydrocephalus

  • A person with Normal Pressure Hydrocephalus (NPH) has fluid inside the brain that does not drain properly, which results in difficulty in walking, slowed thinking and loss of bladder control.
  • Specialized brain scans, lumbar puncture (spinal tap) and a physical examination can lead to a diagnosis.
  • Treatment often involves surgery where a shunt is placed to help drain excess fluid.

Dementia with Lewy Bodies

  • Dementia with Lewy bodies (DLB) is a progressive, neurodegenerative disorder in which abnormal deposits of a protein called alpha-synuclein build up in multiple areas of the brain.
  • DLB first causes progressive problems with memory and fluctuations in thinking, as well as hallucinations. These symptoms are joined later in the course of the disease by parkinsonism with slowness, stiffness and other symptoms similar to PD.
  • While the same abnormal protein (alpha synuclein) is found in the brains of those with PD, when individuals with PD develop memory and thinking problems it tends to occur later in the course of their disease.
  • There are no specific treatments for DLB. Treatment focuses on symptoms.

Multiple System Atrophy

  • Multiple system atrophy (MSA) may resemble PD parkinsonism, but comes with additional symptoms and signs.
  • Symptoms include incoordination (ataxia) and dysfunction in the autonomic nervous system, which automatically controls things such as blood pressure and bladder function. Diagnosis is made based on clinical features. There is no specific test that provides a definitive diagnosis.
  • There is no specific treatment for MSA. Treatment focuses on alleviating symptoms.

Corticobasal syndrome

  • Corticobasal syndrome (CBS) is rare. It usually begins with symptoms affecting one limb.
  • In addition to parkinsonism, other symptoms can include abnormal posturing of the affected limb (dystonia), fast, jerky movements (myoclonus), difficulty with some motor tasks despite normal muscle strength (apraxia), difficulty with language (aphasia) among others.
  • There is no specific test for CBS.
  • Treatment focuses on symptoms. 

Progressive Supranuclear Palsy

  • Progressive supranuclear palsy (PSP) is a disease that mimics PD, particularly early in its course, but that comes with additional distinctive signs and symptoms.
  • Individuals with PSP may fall frequently early in the course of disease. Later symptoms include limitations in eye movements, particularly looking up and down, which also contributes to falls.
  • Those with PSP also often have problems with swallowing (dysphagia), difficulty in producing speech (dysarthria), sleep problems and thinking problems.

Page reviewed by Dr. Ryan Barmore, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

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