The Difference Between Parkinson’s and Parkinsonism

Parkinson’s and Parkinsonism sound the same, and they are very similar. Parkinsonism is defined as several neurological disorders causing movement problems, but there are differences.

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Parkinson’s is one of the most common neurodegenerative causes of Parkinsonism. Parkinsonism is best described as a syndrome that contains lesions in the basal ganglia. In other words, at the base of the forebrain. The basal ganglia controls voluntary motor movement, procedural learning, habit learning, eye movements, emotion, and cognition. Parkinson’s makes up about 80% of parkinsonism.

What is Parkinson’s?

Parkinson’s disease is a brain disorder that progress slowly and can take years to develop. Symptoms include loss of motor control, tremors, slow movement, postural instability, and stiffness. There are also symptoms of depression, gastric problems, cognitive changes, plus many other issues that manifest over time.

Dementia is often associated with Parkinson’s disease. Approximately 20% of patients are also affected by dementia. Depression is a symptom as well.

In the early stages of Parkinson’s, your face may show little or no expression. Arms may not swing when you walk, and your speech may become slurred or very soft.

Other Symptoms of Parkinson’s

• Tremors or shaking usually begin in a limb, and it is often starts with your hands or fingers. You may tend to rub your thumb and forefinger back and forth, and your hand may tremor as you're resting.
• Bradykinesia or slowed movements happen over time. Bradykinesia makes simple tasks difficult. Steps become shortened as you walk, and it may be difficult to get out of a chair. You may also drag your feet as you walk.
• Rigid muscles occur in parts of your body. These stiff and rigid muscles are painful and limit the range of motion
• Impaired balance and posture are changed. Your posture becomes bent over, and you are at risk of falling because of motor issues.
• You will gradually have a decreased ability to perform regular and unconscious movements like blinking, swinging your arms, smiling or even moving.
• Your speech changes with Parkinson’s. Speech may become monotone and not have the usual inflection.
• Writing problems will make handwriting small and messy.

Causes are thought to be hereditary predisposition, environmental toxins, and aging.

What is Parkinsonism?

Parkinsonism refers to a group of neurological disorders that cause problems with movement, gait and tremors. Symptoms are similar to Parkinson’s disease and include symptoms like slow movement, stiffness, and tremors.

Many disorders fall under the definition of parkinsonism, and there are many of these disorders that are not defined or named.

Early on in parkinsonism diseases, it is difficult to know if someone has idiopathic or unknown origins Parkinson’s’ disease or something that is actually mimicking the disease.

Parkinsonism is also known as atypical Parkinson’s’ or Parkinson’s’ s plus, and these symptoms progress rapidly. Early falling, dementia, and hallucinations are easily recognized symptoms.

Parkinsonism or Parkinson’s plus disorders include:

• Vascular Parkinsonism is caused by blood clots in the brain from multiple, but small, strokes, vascular parkinsonism patients have more problems with gait and have issues in their lower body. Vascular parkinsonism progresses slowly.
• Dementia with Lewy Bodies (DLB) is a common cause of dementia in older people. It is second only to Alzheimer’s. Lewy body dementia causes intellectual and functional deterioration. The signs of Parkinson’s disease are apparent, but those with DLB have additional symptoms of changes in thinking, levels of attention, and they frequently have visual hallucinations. There may be no evident tremors with DLB.
• Corticobasal Degeneration or CBD is a very uncommon form of parkinsonism. CBD usually develops after the age of 60. Symptoms include little or no functioning on one side of your body, jerky movements of only one limb, and speech problems. It becomes impossible to use the affected limb, but there is little or no sensory loss. There is no treatment for CBD.
• Drug-induced parkinsonism is challenging to determine if it is Parkinson’s or not, although the tremors and instability are less severe. Drug-induced parkinsonism is the side effect of drugs that drop dopamine levels in the brain. These drugs include calcium channel blockers and stimulants like amphetamines and cocaine. Once the affected person stops taking the drugs, symptoms go away, but it does take time.
• Progressive Supranuclear Palsy or PSP is much more common than ALS or Lou Gehrig's disease, and symptoms often start in the early 60s. Early signs include loss of balance that results in falls, personality changes, and forgetfulness. Visual problems occur about five years after the balance problems and cause the eyes to become weak, paralyzed, and unfocused.
• Multiple System Atrophy or MSA is often referred to as Sy-Drager syndrome. These are a group of disorders where one or more systems in the body stop working. The autonomic nervous system is severely affected early on in the disease. Symptoms include bladder problems and orthostatic hypotension. In orthostatic hypotension, your blood pressure drops so low when you are standing that you often faint. When you are lying down, your blood pressure may be quite high. Other signs are the loss of erectile function (in men), impaired speech, difficulty with breathing and the inability to sweat.

Treatments

Treatments overlap for Parkinson’s and Parkinsonism. Dopaminergic therapies might be useful in some forms of parkinsonism. Regular daily exercise programs are essential for maintaining muscle tone, flexibility, and strength. If you find that movements are painful, take it slow, but do try and move.

Conventional treatments for both Parkinson’s and Parkinsonism include occupational and physical plus speech therapy, antidepressants, and botulinum toxins for dystonia (a movement disorder where your muscle contract involuntarily and cause repetitive or twisting movements).

There are prescription medications that may help, and these include generic versus branded drugs. There are generic formulations of carbidopa or levodopa, dopamine agonists, monoamine oxidase inhibitors and anticholinergics. There is a disclaimer that states if you are in an advanced state of Parkinson’s or Parkinsonism, stay with a branded drug. Switching from branded drugs to generic may have an adverse effect.

Currently, the most recommended medication on the market is Levodopa. Levodopa is a pill designed to convert dopamine in the brain, which is an organic chemical that is synthesized in the brain and kidneys and plays a significant role in transferring messages for movement. Damaged or missing dopamine is the primary cause of Parkinsonism and Parkinson’s Disease.

Whatever you do, work with your doctor to find the best combination of drugs and medications that will help with your symptoms.

Most treatments are aimed to treat the symptoms of Parkinson’s Disease and Parkinsonism. Procedures are developed to give a patient a better quality of life. At this time, there is no cure, and treatments often don’t work.