Atypical parkinsonisms are conditions in which an individual experiences some of the signs and symptoms of Parkinson's disease (PD) but does not have PD. These include corticobasal degeneration (CBD), Lewy body dementia (LBD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP).
In our recent webinar on atypical parkinsonisms, panelists discussed these conditions and how to best manage them. Here we answer some of the most common questions received from our audience during the presentation:
Can brain imaging techniques, such as MRI or DaTSCAN™, be used to diagnose Parkinson's disease or atypical parkinsonisms?
Magnetic resonance imaging (MRI) is a specialized technique that can take pictures of the structures in your brain. DaTSCAN™ is another imaging method that shows information about the dopamine cells in your brain. These tools can help rule out some neurological conditions that can look like parkinsonisms (e.g., essential tremor), but they cannot be used to definitively determine a diagnosis or tell Parkinson's from atypical parkinsonisms.
Movement disorder specialists, neurologists with expertise in Parkinson's and atypical parkinsonisms, take many factors into consideration to assign a diagnosis. Find a specialist in your area by using our Movement Disorder Specialist Finder tool.
If I have this symptom, does that mean I have that atypical parkinsonisms?
While some symptoms of CBD, LBD, MSA and PSP are more often linked to one of the diseases than others, these conditions share many of the same symptoms. Falling backward, for example, is often part of PSP, but such an experience does not mean one definitely has that disease.
"Each of these diseases is a spectrum, and the spectrums of the different diseases overlap at their edges," said panelist Lawrence I. Golbe, MD, of the Rutgers Robert Wood Johnson Medical School.
Individuals with atypical parkinsonisms experience a poorer or short-term response to levodopa and quicker progression of symptoms, which may be a clue that they have something other than Parkinson's disease. A movement disorder specialist can take a person's full experience into consideration before changing or making a diagnosis.
What treatments are available for atypical parkinsonisms?
As with PD, no disease-modifying therapies to slow or stop the course of these diseases are available, so treatment is aimed at easing symptoms.
Individuals with atypical parkinsonisms may get some benefit from levodopa, and this is often the first choice of therapy for motor symptoms. However, it may not provide significant benefit or effectiveness may wane rapidly. For dystonia, Botox injections can be helpful, and for non-motor symptoms (such as memory, behavioral or sleep disturbances), doctors may prescribe a variety of other medications.
Non-pharmacological methods are also effective for managing many of these symptoms. Physical and occupational therapists can develop programs aimed at maintaining mobility, preventing falls or falling in ways to minimize injury. Speech therapists can recommend language exercises for speech disturbances and dietary and/or mealtime adjustments for swallowing problems. Lifestyle changes -- using compression stockings to help prevent blood pressure from dropping and eating fiber to combat constipation -- may also be helpful.
Researchers are trying to learn more about these diseases and develop new treatments. If you are interested in participating in atypical parkinsonism research, visit Fox Trial Finder to learn how you can get involved.
To learn more about atypical parkinsonisms, watch the full webinar.
Questions on other aspects of life with Parkinson's or atypical parkinsonism? Review our full webinar library of Parkinson's topics from genetics to gait problems.