Parkinsonism

Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia, rigidity, and postural instability.[1][2] It is found in Parkinson's disease (PD), after which it is named, dementia with Lewy bodies (DLB), Parkinson's disease dementia (PDD), and many other conditions. A wide range of causes may lead to this set of symptoms, including neurodegenerative conditions, drugs, toxins, metabolic diseases, and neurological conditions other than PD.[3]

Not to be confused with Parkinson's disease.
Parkinsonism
SpecialtyNeurology 
Causes

Causes

Drug-induced

About 7% of people with parkinsonism developed symptoms as a result of side effects of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol), and rarely, antidepressants. 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.[4]

Toxins

Evidence exists of a link between exposure to pesticides and herbicides and PD; a two-fold increase in risk was seen with paraquat or maneb/mancozeb exposure.[5]

Chronic manganese (Mn) exposure has been shown to produce a parkinsonism-like illness characterized by movement abnormalities.[6] This condition is not responsive to typical therapies used in the treatment of PD, suggesting an alternative pathway than the typical dopaminergic loss within the substantia nigra.[6] Manganese may accumulate in the basal ganglia, leading to the abnormal movements.[7] A mutation of the SLC30A10 gene, a manganese efflux transporter necessary for decreasing intracellular Mn, has been linked with the development of this Parkinsonism-like disease.[8] The Lewy bodies typical to PD are not seen in Mn-induced parkinsonism.[7]

Diagnosis

Parkinsonism occurs in many conditions.

Neurodegenerative conditions and Parkinson plus syndrome[9]
Drug-induced ("pseudoparkinsonism")
Infectious
Toxins
Trauma
Vascular
Other

Essential tremor

A 2018 review article said that the relationship (if any) between Parkinson's disease and essential tremor is not clear.[31]

References
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  2. Tobottom BJ, Weiner WJ, Shulman LM (2009-09-28). "Chapter 42: Parkinsonism". In Lisak RP, Truong DD, Carroll W, Bhidayasiri R (eds.). International Neurology: A Clinical Approach. Blackwell Publishing Ltd. pp. 152–58. ISBN 978-1-405-15738-4.
  3. Christine CW, Aminoff MJ (September 2004). "Clinical differentiation of parkinsonian syndromes: prognostic and therapeutic relevance". The American Journal of Medicine. 117 (6): 412–9. doi:10.1016/j.amjmed.2004.03.032. PMID 15380498.
  4. "Information Sheet: Drug-induced Parkinsonism" (PDF). Parkinson’s Disease and Society. Archived from the original (PDF) on 2013-06-26. Retrieved 2013-04-15.
  5. Pezzoli G, Cereda E (May 2013). "Exposure to pesticides or solvents and risk of Parkinson disease". Neurology (Meta-analysis). 80 (22): 2035–41. doi:10.1212/WNL.0b013e318294b3c8. PMID 23713084.
  6. Guilarte TR, Gonzales KK (August 2015). "Manganese-Induced Parkinsonism Is Not Idiopathic Parkinson's Disease: Environmental and Genetic Evidence". Toxicological Sciences (Review). 146 (2): 204–12. doi:10.1093/toxsci/kfv099. PMC 4607750. PMID 26220508.
  7. Kwakye GF, Paoliello MM, Mukhopadhyay S, Bowman AB, Aschner M (July 2015). "Manganese-Induced Parkinsonism and Parkinson's Disease: Shared and Distinguishable Features". International Journal of Environmental Research and Public Health (Review). 12 (7): 7519–40. doi:10.3390/ijerph120707519. PMC 4515672. PMID 26154659.
  8. Peres TV, Schettinger MR, Chen P, Carvalho F, Avila DS, Bowman AB, Aschner M (November 2016). "Manganese-induced neurotoxicity: a review of its behavioral consequences and neuroprotective strategies". BMC Pharmacology & Toxicology (Review). 17 (1): 57. doi:10.1186/s40360-016-0099-0. PMC 5097420. PMID 27814772.
  9. Jankovic J, Lang AE (2004). "Diagnosis and Assessment". In Bradley, Walter George (ed.). Neurology in Clinical Practice: Principles of diagnosis and management. Volume 1. Taylor & Francis. pp. 295–96. ISBN 9789997625885.
  10. Finger EC (April 2016). "Frontotemporal Dementias". Continuum (Review). 22 (2 Dementia): 464–89. doi:10.1212/CON.0000000000000300. PMC 5390934. PMID 27042904.
  11. McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. (July 2017). "Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium". Neurology (Review). 89 (1): 88–100. doi:10.1212/WNL.0000000000004058. PMC 5496518. PMID 28592453.
  12. Shuaib UA, Rajput AH, Robinson CA, Rajput A (March 2016). "Neuroleptic-induced Parkinsonism: Clinicopathological study". Movement Disorders. 31 (3): 360–5. doi:10.1002/mds.26467. PMC 5064745. PMID 26660063.
  13. Louis ED, Ottman R (November 2013). "Is there a one-way street from essential tremor to Parkinson's disease? Possible biological ramifications". European Journal of Neurology (Review). 20 (11): 1440–4. doi:10.1111/ene.12256. PMC 3801177. PMID 24033795.
  14. Fabrizi, Monaco, Dalla Libera (2004). "Parkinsonian syndrome following MDMA (Ecstasy) addiction". Movement Disorders. 19: S73–S74.CS1 maint: multiple names: authors list (link)
  15. Maltête D, Guyant-Maréchal L, Mihout B, Hannequin D (March 2006). "Movement disorders and Creutzfeldt-Jakob disease: a review". Parkinsonism & Related Disorders. 12 (2): 65–71. doi:10.1016/j.parkreldis.2005.10.004. PMID 16364674.
  16. Tse W, Cersosimo MG, Gracies JM, Morgello S, Olanow CW, Koller W (August 2004). "Movement disorders and AIDS: a review". Parkinsonism & Related Disorders. 10 (6): 323–34. doi:10.1016/j.parkreldis.2004.03.001. PMID 15261874.
  17. Carod-Artal FJ (2003). "[Neurological syndromes linked with the intake of plants and fungi containing a toxic component (I). Neurotoxic syndromes caused by the ingestion of plants, seeds and fruits]". Revista de Neurologia (Review) (in Spanish). 36 (9): 860–71. PMID 12717675.
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  19. Watanabe Y, Himeda T, Araki T (January 2005). "Mechanisms of MPTP toxicity and their implications for therapy of Parkinson's disease" (PDF). Medical Science Monitor. 11 (1): RA17–23. PMID 15614202.
  20. Nandipati S, Litvan I (September 2016). "Environmental Exposures and Parkinson's Disease". International Journal of Environmental Research and Public Health (Review). 13 (9): 881. doi:10.3390/ijerph13090881. PMC 5036714. PMID 27598189.
  21. Weiss J. Chapter 151. Toluene and Xylene. In: Olson KR, ed. Poisoning & Drug Overdose. 6th ed. New York: McGraw-Hill; 2012. http://www.accessmedicine.com/content.aspx?aID=55982958. Accessed April 21, 2013.
  22. Uitti RJ, Snow BJ, Shinotoh H, Vingerhoets FJ, Hayward M, Hashimoto S, Richmond J, Markey SP, Markey CJ, Calne DB (May 1994). "Parkinsonism induced by solvent abuse". Annals of Neurology. 35 (5): 616–9. doi:10.1002/ana.410350516. PMID 8179306.
  23. Jubault T, Brambati SM, Degroot C, Kullmann B, Strafella AP, Lafontaine AL, Chouinard S, Monchi O (December 2009). Gendelman HE (ed.). "Regional brain stem atrophy in idiopathic Parkinson's disease detected by anatomical MRI". PLOS ONE. 4 (12): e8247. Bibcode:2009PLoSO...4.8247J. doi:10.1371/journal.pone.0008247. PMC 2784293. PMID 20011063.
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  27. Apartis E, Tison F, Arné P, Jedynak CP, Vidailhet M (November 2001). "Fast orthostatic tremor in Parkinson's disease mimicking primary orthostatic tremor". Movement Disorders. 16 (6): 1133–6. doi:10.1002/mds.1218. PMID 11748748.
  28. Panzer J, Dalmau J (August 2011). "Movement disorders in paraneoplastic and autoimmune disease". Current Opinion in Neurology. 24 (4): 346–53. doi:10.1097/WCO.0b013e328347b307. PMC 3705177. PMID 21577108.
  29. Liu Y, Lu Y, Zhang X, Xie S, Wang T, Wu T, Wang C (November 2016). "A case of rapid-onset dystonia-parkinsonism accompanied by pyramidal tract impairment". BMC Neurology. 16 (1): 218. doi:10.1186/s12883-016-0743-8. PMC 5105251. PMID 27835968.
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Classification
External resources
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