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Parkinsonism

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"Parkinson's syndrome" redirects here. Not to be confused withParkinson's disease.
Parkinsonism
SpecialtyNeurologyEdit this on Wikidata
Causes

Parkinsonismis a clinicalsyndromecharacterized bytremor,bradykinesia(slowed movements),rigidity,andpostural instability.[1][2]Both hypokinetic (bradykinesia and akinesia) as well as hyperkinetic (cogwheel rigidity and tremors at rest) features are displayed by Parkinsonism.[3]These are the fourmotor symptomsfound inParkinson's disease(PD) – after which it is named –dementia with Lewy bodies(DLB),Parkinson's disease dementia(PDD), and many other conditions. This set of symptoms occurs in a wide range of conditions and may have many causes, includingneurodegenerativeconditions, drugs,toxins,metabolic diseases,and neurological conditions other than PD.[4]

Signs and symptoms

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Parkinsonism is a clinicalsyndromecharacterized by the fourmotor symptomsfound inParkinson's disease:tremor,bradykinesia(slowed movements),rigidity,andpostural instability.[1][2]

Parkinsonismgaitproblems can lead to falls and serious physical injuries. Other common symptoms include:

Conditions

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Parkinsonism occurs in many conditions.

Neurological

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Neurodegenerativeconditions andParkinson-plus syndromesthat can cause parkinsonism include:[6]

Infectious

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Toxins

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Evidence exists to show a link between exposure topesticidesandherbicidesand PD; a two-fold increase in risk was seen withparaquatormaneb/mancozebexposure.[12]

Chronicmanganese(Mn) exposure has been shown to produce a parkinsonism-like illness characterized by movement abnormalities.[13]This condition is not responsive totypical therapies used in the treatment of PD,suggesting an alternative pathway than the typicaldopaminergicloss within thesubstantia nigra.[13]Manganese may accumulate in thebasal ganglia,leading to the abnormal movements that characterize parkinsonism.[14]A mutation of theSLC30A10gene, a manganese efflux transporter necessary for decreasing intracellular Mn, has been linked with the development of this parkinsonism-like disease.[15]TheLewy bodiestypical to PD are not seen in Mn-induced parkinsonism.[14]

Agent Orangemay be a cause of parkinsonism, although evidence is inconclusive and further research is needed.[16]

Other toxins that have been associated with parkinsonism are:

Vascular

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Other

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Differential diagnosis

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Secondary parkinsonism, including vascular parkinsonism and drug-induced parkinsonism.[35][36]

Drug-induced parkinsonism

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About 7% of people with parkinsonism developed symptoms as a result of side effects of medication, mainly neurolepticantipsychoticsespecially thephenothiazines(such asperphenazineandchlorpromazine),thioxanthenes(such asflupentixolandzuclopenthixol) andbutyrophenones(such ashaloperidol), and rarely,antidepressants.Yet another drug that can induce parkinsonism is theantihistaminicmedicationcinnarizine,usually prescribed for motion sickness; this is because besides antagonizinghistamine receptorsthis drug antagonizes thedopamine D2 receptors.[37]The incidence of drug-induced parkinsonism increases with age. Drug-induced parkinsonism tends to remain at its presenting level and does not worsen like Parkinson's disease.[38]

Implicated medications include:

Society and culture

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In the United States, the 2021National Defense Authorization Act(NDAA) added parkinsonism to the list of presumptive conditions associated withAgent Orangeexposure, enabling affected service members to receiveVeterans Affairsdisability benefits.[42]

References

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