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Atypical Parkinsonism

What is Atypical Parkinsonism?

Atypical Parkinsonism, also known as “Parkinson’s Plus,” is a group of conditions that present symptoms similar to Parkinson’s disease (PD), including tremors, slowness, and stiffness, which are collectively referred to as “parkinsonism.”

Although individuals with atypical Parkinsonism may resemble Parkinson’s patients, they often exhibit additional symptoms not typically associated with Parkinson’s. Given the similarity of symptoms to Parkinson’s, especially in the early stages, misdiagnosis can occur. Furthermore, their symptoms tend to progress more rapidly and are less responsive to PD medications.

What are the Types and Symptoms of Atypical Parkinsonism?

These conditions are caused by abnormal protein accumulation in certain brain cells, leading to cell death and brain shrinkage. The type and location of protein deposits determine the symptoms and diagnosis of each condition.

Patients can experience disruption of autonomic functioning. Such manifestations may be expressed through issues such as:

  • difficulty with bladder control
  • frequent dizzy spells
  • irregular bowel movements,
  • decreased sensitivity to temperature
  • coloration of hands and feet
  • coordination problems
  • erectile dysfunction

DLB is a leading cause of dementia among the elderly and usually affects individuals in their 60s.The most common signs of this condition are:

  • Changes in attention or alertness
  • Confusion
  • Gait and balance problems
  • Visual hallucinations
  • Sleep disorders

It is the third most common form of atypical Parkinsonism and has the classic Parkinsonian motor symptoms of:

  • Tremor and rigidity
  • Falls
  • Gait and balance symptoms become very disabling in later stages
  • Slowed voluntary movements of the eyes (vertical supranuclear gaze palsy)
  • Slurred speech

The disorder is characterized by asymmetric involvement of both the arms and legs, where stiffness or rigidness is often accompanied by an arm that fails to swing properly.

  • Dystonia (abnormal posture of limbs)
  • Myoclonus (sudden jerking)
  • Difficulty with simple arithmetic
  • Inability to demonstrate or recognize the use of common objects
  • Alien limb phenomenon (feeling of the arm or leg being a foreign structure)
  • Repeatedly picking at buttons or zippers on clothing without realizing it

Diagnosis of Atypical Parkinsonism

Diagnosis of Atypical Parkinsonism relies on a comprehensive evaluation of the individual’s medical history and a physical examination by a Movement Disorders Neurologist, as there are no specific blood or imaging tests to diagnose the condition.

Treatment Options for Atypical Parkinsonism

Atypical Parkinsonism cannot be cured, but treatments are available at Melbourne NeuroCare to ease symptoms.

Levodopa may be prescribed for movement symptoms but may not provide significant or long-lasting benefits.

For dystonia, botulinum toxin injections into the muscles can help.

Occupational and physical therapy can improve walking and balance and prevent falls.

Medications like Rivastigmine, Donepezil, Memantine, and Galantamine may treat memory and thinking problems.

Atypical antipsychotics can treat hallucinations in DLB, but with caution, because they can worsen symptoms and have significant side effects.

Speech therapy can help with speech and swallowing problems. A team approach, including neurologists, therapists, social workers, and palliative care specialists, can help address the symptoms of atypical Parkinsonism.

Book an appointment

If you or a loved one is suffering from a movement disorder, our team at Melbourne Neurocare can help. We invite you to book a consultation with one of our movement disorder neurologists. Your health is our top priority, and we look forward to helping you achieve the best possible outcome.