Parkinson’s or Parkinsonism? Understanding Your Diagnosis
Hearing the words Parkinson’s disease or parkinsonism can feel overwhelming. You may have questions about what the diagnosis means, what caused your symptoms, what to expect next, and whether treatment can help.
One of the most important things to know is that Parkinson’s disease and parkinsonism are not exactly the same thing. Parkinsonism is a broad term used to describe a group of neurological conditions that can cause symptoms similar to those seen in Parkinson’s disease. Parkinson’s disease is the most common cause of parkinsonism, but several other conditions can produce similar movement problems.
Understanding the differences can help you feel more informed and prepared as you work with your healthcare team.
What Is Parkinsonism?
Think of parkinsonism as an umbrella term. It describes a collection of movement symptoms that can occur for several different reasons.
The symptoms commonly associated with parkinsonism include:
Tremor: Shaking, often in a hand or foot while the body is at rest.
Bradykinesia: Slowness of movement that can affect walking, the arms and legs, facial expressions, or everyday activities.
Rigidity: Stiffness or tightness in the muscles, which may affect the arms, legs, neck, or trunk.
A person with parkinsonism may have some or all of these symptoms. The challenge for doctors is determining why those symptoms are happening.
Some forms of parkinsonism are caused by the gradual degeneration of nerve cells in the brain. Others may result from medications, problems with blood flow to the brain, or other neurological conditions.
Parkinson’s Disease Is One Type of Parkinsonism
Parkinson’s disease is a progressive neurological disorder. This means that symptoms generally develop and change over time. Many of the movement symptoms associated with Parkinson’s are related to changes in nerve cells that produce dopamine. Dopamine is a chemical messenger that helps different parts of the brain communicate. It plays an important role in controlling movement, but it is also involved in learning, motivation, and emotional responses. As dopamine-producing nerve cells become damaged or are lost, movement can become slower and more difficult to control. It's important to remember that Parkinson’s is different for everyone. One person's symptoms and progression may look very different from another person's experience.
Why Is Parkinsonism Sometimes Difficult to Diagnose?
If you're having symptoms such as shaking, stiffness, or difficulty walking, it may seem like there should be a simple test to determine whether you have Parkinson’s disease.
Unfortunately, there isn't one definitive test that can diagnose Parkinson’s or every form of parkinsonism.
Instead, doctors consider many pieces of information, including your symptoms, medical history, neurological examination, medications, and how your symptoms change over time.
This can sometimes make the diagnostic process frustrating or lengthy. You may initially receive one diagnosis and later learn that another condition better explains your symptoms.
That doesn't necessarily mean that your healthcare team made a mistake. Some forms of parkinsonism can look remarkably similar, particularly in the early stages.
Why the Correct Diagnosis Matters
Although different forms of parkinsonism can look alike, their causes and treatments can be very different. For example, vascular parkinsonism is associated with damage to the brain's blood vessels, often from small strokes. Parkinson’s disease, on the other hand, is a neurodegenerative disorder involving the loss or dysfunction of specific nerve cells.
Medications used for Parkinson’s may not work as well for someone whose symptoms are caused by vascular disease. That's why your doctor may need time to rule out other possibilities before settling on the most likely diagnosis. If you are going through this process, remember that taking time to get the diagnosis right is an important part of getting the right care.
Six Other Forms of Parkinsonism
There are several different conditions that can cause parkinsonian symptoms. Below is a closer look at six important forms and some of the features that can help distinguish them from typical Parkinson’s disease.
1. Drug-Induced Parkinsonism
Sometimes, Parkinson-like symptoms can be caused by medication.
Drug-induced parkinsonism (DIP) occurs when certain medications interfere with dopamine signaling in the brain. Some medications used to treat psychiatric conditions and certain gastrointestinal problems can cause these symptoms.
Symptoms may include stiffness, slowed movement, tremor, and difficulty walking.
One encouraging aspect of drug-induced parkinsonism is that symptoms may improve when the medication responsible is reduced or discontinued.
However, never stop taking a prescribed medication on your own. If you suspect a medication may be contributing to your symptoms, talk with your doctor. They can determine whether the medication should be changed or gradually reduced.
2. Dementia With Lewy Bodies
Dementia with Lewy bodies (DLB) is another condition involving abnormal deposits of a protein called alpha-synuclein.
People with DLB can experience changes in thinking and memory as well as movement symptoms.
They may develop:
Changes in attention or alertness
Problems with thinking or memory
Visual hallucinations
Stiffness
Slowed movement
Walking and balance difficulties
Tremor in some cases
3. Multiple System Atrophy
Multiple system atrophy (MSA) is a progressive neurological disorder that affects movement as well as the body's autonomic nervous system.
The autonomic nervous system controls many functions that happen automatically, such as blood pressure, sweating, bladder function, and certain aspects of sexual function.
People with MSA may experience movement difficulties along with problems such as:
Low blood pressure, particularly when standing
Bladder problems
Changes in sweating
Balance difficulties
Stiffness or slowed movement
4. Progressive Supranuclear Palsy
The name progressive supranuclear palsy (PSP) may sound complicated, but some of its features can help doctors distinguish it from Parkinson’s disease.
PSP affects parts of the brain involved in eye movement, balance, and coordination.
People with PSP may experience:
Difficulty moving the eyes, particularly when looking down
Blurred vision
Balance problems
Frequent falls
Stiffness
Speech difficulties
Problems with swallowing
People with PSP may also develop a tendency to lean or fall backward.
PSP is associated with abnormal accumulation of a protein called tau.
5. Vascular Parkinsonism
Vascular parkinsonism is caused by problems with the blood supply to the brain, often related to small strokes or other cerebrovascular damage.
The symptoms often affect the lower body and may include:
Shuffling while walking
Difficulty getting around
Poor balance
Unsteadiness
Slowed movement
6. Corticobasal Degeneration
Corticobasal degeneration (CBD) is a rare neurological disorder that affects several parts of the brain involved in movement and other functions.
One of its more noticeable features is that symptoms often begin on one side of the body.
A person may have difficulty using one hand or leg, experience stiffness or involuntary muscle jerks, or struggle with purposeful movements. For example, everyday activities such as buttoning a shirt, using utensils, or performing other familiar tasks may become unexpectedly difficult.
Speech and swallowing problems can also occur.
What About Treatment?
Treatment for parkinsonism depends on what is causing the symptoms.
For Parkinson’s disease, medications such as levodopa can be very helpful in managing movement symptoms. Some people with other forms of parkinsonism may also experience some benefit from levodopa, but atypical forms often respond less strongly.
That doesn't mean there is nothing that can be done.
In fact, non-medication treatments can be an important part of care, regardless of the specific diagnosis.
Your healthcare team may recommend:
Exercise to maintain strength, flexibility, balance, and overall fitness
Physical therapy to improve walking, mobility, and balance
Occupational therapy to make everyday activities easier and safer
Speech therapy to address communication or swallowing difficulties
Nutritional support when diet, weight, or swallowing becomes a concern
Counseling or psychotherapy for individuals and families coping with the emotional challenges of neurological disease
Support groups to connect with other people who understand what you're experiencing
Treatment isn't only about medications. It's also about helping you stay active, safe, independent, and connected to the people and activities that matter to you.