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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{SI}}
{{Parkinsonism}}
{{CMG}}
{{CMG}}
{{SK}} Parkinson's syndrome; atypical Parkinson's; secondary Parkinson's
==[[Parkinsonism overview|Overview]]==


==Overview==
==[[Parkinsonism historical perspective|Historical Perspective]]==
'''Parkinsonism''' (also known as '''Parkinson's syndrome''', '''atypical Parkinson's''', or '''secondary Parkinson's''') is a neurological [[syndrome]] characterized by [[tremor]], [[hypokinesia]], [[spasticity|rigidity]], and [[balance disorder|postural instability]].<ref name=Aminoff_2005>{{cite book | author = Aminoff MJ, Greenberg DA, Simon RP | title = Clinical Neurology | publisher = Lange: McGraw-Hill Medical | edition = 6th ed. | pages = 241&ndash;5 |year = 2005 | isbn = 0071423605 }}</ref> The underlying causes of parkinsonism are numerous, and diagnosis can be complex.<ref>{{cite journal | author = Tuite PJ, Krawczewski K | title = Parkinsonism: a review-of-systems approach to diagnosis | journal = Seminars in neurology | volume = 27 | issue = 2 | pages = 113-22 | year = 2007 | pmid = 17390256 | doi = 10.1055/s-2007-971174}}</ref> While the [[neurodegenerative]] condition [[Parkinson's disease]] (PD) is the most common cause of parkinsonism, a wide-range of other [[Etiology|etiologies]] can lead to a similar set of symptoms, including some [[toxins]], a few [[metabolic disease]]s, and a handful of non-PD neurological conditions.<ref>{{cite journal | author = Christine CW, Aminoff MJ | title = Clinical differentiation of parkinsonian syndromes: prognostic and therapeutic relevance | journal = Am. J. Med. | volume = 117 | issue = 6 | pages = 412-9 | year = 2004 | pmid = 15380498 | doi = 10.1016/j.amjmed.2004.03.032}}</ref>  Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), piperazines (such as ziprasidone), and rarely, antidepressants.


==Differential Diagnosis==
==[[Parkinsonism pathophysiology|Pathophysiology]]==
If PD has been excluded, the [[differential diagnosis]] or list of potential causes for this syndrome includes:
* [[AIDS]] can sometimes lead to the symptoms of Parkinson's disease, due to commonly causing dopaminergic dysfunction.<ref>{{cite journal | author = Tse W, Cersosimo MG, Gracies JM, ''et al'' | title = Movement disorders and AIDS: a review | journal = Parkinsonism Relat. Disord. | volume = 10 | issue = 6 | pages = 323-34 | year = 2004 | pmid = 15261874 | doi = 10.1016/j.parkreldis.2004.03.001}}</ref>
* [[Corticobasal degeneration]]<ref name=Aminoff_2005/>
* [[Creutzfeldt-Jakob disease]]<ref>{{cite journal | author = Maltête D, Guyant-Maréchal L, Mihout B, Hannequin D | title = Movement disorders and Creutzfeldt-Jakob disease: a review | journal = Parkinsonism Relat. Disord. | volume = 12 | issue = 2 | pages = 65-71 | year = 2006 | pmid = 16364674 | doi = 10.1016/j.parkreldis.2005.10.004}}</ref>
* [[Diffuse Lewy body disease]]<ref name=Aminoff_2005 />
* Drug-induced parkinsonism (due to drugs such as [[antipsychotics]], [[metoclopramide]], [[MPTP]]<ref name=Watanabe_2005>{{cite journal | author = Watanabe Y, Himeda T, Araki T | title = Mechanisms of MPTP toxicity and their implications for therapy of Parkinson's disease | journal = Med. Sci. Monit. | volume = 11 | issue = 1 | pages = RA17-23 | year = 2005 | pmid = 15614202 | url =  http://www.medscimonit.com/pub/vol_11/no_1/5333.pdf | format = PDF}}</ref>)<ref name=Aminoff_2005/>
* [[Encephalitis lethargica]]<ref name=Aminoff_2005/>
* [[Multiple system atrophy]]<ref>{{cite journal | author = Wenning GK, Geser F | title = Multiple system atrophy | journal = Rev. Neurol. (Paris) | volume = 159 | issue = 5 Pt 2 | pages = 3S31-8 | year = 2003 | pmid = 12773886 | doi = }}</ref>
* [[Pantothenate kinase-associated neurodegeneration]] (Hallervorden-Spatz syndrome)<ref name=Uc_2003>{{cite journal | author = Uc EY, Rodnitzky RL | title = Childhood dystonia | journal = Seminars in pediatric neurology | volume = 10 | issue = 1 | pages = 52-61 | year = 2003 | pmid = 12785748 | doi =  | doi = 10.1016/S1071-9091(02)00010-4 <!--Retrieved from CrossRef by DOI bot-->}}</ref>
* [[Progressive supranuclear palsy]]<ref name=Aminoff_2005 />
* Toxicity due to substances such as [[carbon monoxide]],<ref name=Harrison>{{cite book | author = DeLong MR, Juncos JL  | title = Parkinson's Disease and Other Movement Disorders. ''In:'' Harrison's Principles of Internal Medicine | pages = p. 2414 | edition = 16th ed.| publisher = McGraw-Hill Professional | year = 2004 | isbn = 0-07-140235-7 }}</ref> [[carbon disulfide]],<ref name=Harrison/> [[Manganism|manganese]],<ref name=Harrison/> [[paraquat]],<ref>{{cite journal |author=Dinis-Oliveira RJ, Remião F, Carmo H, ''et al'' |title=Paraquat exposure as an etiological factor of Parkinson's disease |journal=Neurotoxicology |volume=27 |issue=6 |pages=1110-22 |year=2006 |pmid=16815551 |doi=10.1016/j.neuro.2006.05.012}}</ref>  [[hexane]], [[rotenone]], and [[toluene]].
* Vascular parkinsonism<ref>{{cite journal | author = Thanvi B, Lo N, Robinson T | title = Vascular Parkinsonism--an important cause of parkinsonism in older people | journal = Age and ageing | volume = 34 | issue = 2 | pages = 114-9 | year = 2005 | pmid = 15713855 | doi = 10.1093/ageing/afi025 | url = http://ageing.oxfordjournals.org/cgi/reprint/34/2/114 | format = PDF}}</ref>
* [[Wilson's disease]] is a genetic disorder in which there is an abnormal accumulation of copper. The excess copper can lead to the formation of a copper-dopamine complex, which leads to the oxidation of dopamine to aminochrome.<ref>{{cite journal |author=Członkowska A, Tarnacka B, Möller JC, ''et al'' |title=Unified Wilson's Disease Rating Scale - a proposal for the neurological scoring of Wilson's disease patients |journal=Neurol. Neurochir. Pol. |volume=41 |issue=1 |pages=1-12 |year=2007 |pmid=17330175 |doi=}}</ref>
* [[Paraneoplastic syndrome]]. Neurological symptoms caused by antibodies associated with various cancers.


==References==
==[[Parkinsonism causes|Causes]]==
{{Reflist|2}}


===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Cytarabine]], [[Fluphenazine]], [[Perphenazine]], [[Thiothixene]], [[Thioridazine hydrochloride]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
* [[Cytarabine]]
* [[Thioridazine hydrochloride]]
{{col-break|width=33%}}
* Disease B
{{col-break|width=33%}}
* Disease C
{{col-end}}
==[[Parkinsonism differential diagnosis|Differentiating Parkinsonism from other Diseases]]==
==[[Parkinsonism epidemiology and demographics|Epidemiology and Demographics]]==
==[[Parkinsonism risk factors|Risk Factors]]==
==[[Parkinsonism natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Diagnosis==
[[Parkinsonism history and symptoms|History and Symptoms]] | [[Parkinsonism physical examination|Physical Examination]] |[[Parkinsonism laboratory findings|Laboratory Findings]] | [[Parkinsonism CT|CT]] | [[Parkinsonism MRI|MRI]] | [[Parkinsonism other imaging findings|Other Imaging Findings]] |[[Parkinsonism other diagnostic studies|Other Diagnostic Studies]]
==Treatment==
[[Parkinsonism medical therapy|Medical Therapy]] | [[Parkinsonism surgery|Surgery]] | [[Parkinsonism primary prevention|Primary Prevention]] | [[Parkinsonism secondary prevention|Secondary Prevention]] | [[Parkinsonism cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Parkinsonism future or investigational therapies|Future or Investigational Therapies]]
== Case Studies ==
[[Parkinsonism case study one|Case #1]]


[[pt:Parkinsonismo]]
[[pt:Parkinsonismo]]
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{{WS}}


[[Category:Primary care]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Geriatrics]]
[[Category:Geriatrics]]
[[Category:Disease]]
[[Category:Disease]]

Latest revision as of 23:35, 29 July 2020

For patient information click here

Parkinsonism Microchapters

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Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Parkinsonism from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Risk calculators and risk factors for Parkinsonism

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Synonyms and keywords: Parkinson's syndrome; atypical Parkinson's; secondary Parkinson's

Overview

Historical Perspective

Pathophysiology

Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Cytarabine, Fluphenazine, Perphenazine, Thiothixene, Thioridazine hydrochloride
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Differentiating Parkinsonism from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination |Laboratory Findings | CT | MRI | Other Imaging Findings |Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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