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Parkinsonism is a term used to describe a collection of movement symptoms that include slowness (bradykinesia), stiffness (rigidity), tremor, and balance issues (postural instability). Any condition with these movement symptoms falls under the umbrella of parkinsonism.

Parkinsonian disorders (parkinsonism) can be classified into two major groups: primary and secondary.

Primary Parkinsonism

Primary parkinsonian disorders include Parkinson’s disease (PD) and atypical parkinsonian disorders.

Secondary Parkinsonism

There are many secondary or acquired causes of parkinsonism.

Atypical Parkinson’s Conditions

Parkinsonian disorders and Levodopa

Various parkinsonian disorders can be categorized based on how they respond to the medication called levodopa. PD tends to respond well to levodopa therapies, while most atypical parkinsonian disorders do not. Sometimes people with parkinsonian symptoms who do not respond well to levodopa may be referred to as having parkinsonism. This can be confusing since parkinsonism technically refers to a set of movement symptoms, rather than a specific diagnosis.

Understanding Your Diagnosis

Despite recent research and diagnostic advances, the diagnosis of PD and types of atypical parkinsonian still relies primarily on a clinical evaluation. There are many overlapping signs and symptoms among PD, atypical parkinsonisms, and secondary parkinsonisms, making it difficult to diagnose. An accurate diagnosis can take months or even years to determine.

You may be diagnosed right away with “typical” or idiopathic Parkinson’s, or your doctor may tell you that you have parkinsonism. A “diagnosis” of parkinsonism may simply mean that you have movement symptoms, like slowness, rigidity and tremor. It might also mean that your doctor does not have enough information to know if your symptoms will respond well to levodopa.

Additionally, some doctors use the term parkinsonism interchangeably with atypical parkinsonism. Talk to your doctor if you have questions about what your diagnosis means.

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

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