Parkinsonism is a term used to describe a set of motor characteristics that include a progressive decrease in speed (bradykinesia) and range of movement, along with resting tremor or rigidity. However, conditions other than PD can also present these symptoms, resembling Parkinson's. Listed below are the most common medical conditions that can cause parkinsonism. 

【Essential tremor】

⭐Essential tremor (ET) is a tremor that involves the hands or forearms and occurs when the extremities are active. It typically manifests on both sides of the body. Often the tremor is also present in the head or noticeable in the voice. This is different from tremor in PD, which usually starts in one limb and occurs at rest.

⭐The incidence of ET increases with age, although it may be present in childhood or early adulthood. There is often a family history of tremor, especially in those with younger ages of tremor onset.

⭐Like PD, the diagnosis of ET is clinical; that is, after a doctor gathers information about your symptoms and performs a physical examination. Treatment is usually done using medications, although surgery may be used in severe cases.

⭐ET is believed to be a different condition from PD, although sometimes the symptoms can overlap.

⭐Evidence suggests that those with essential tremor may have some higher risk of developing PD than the general population.

【Normal pressure hydrocephalus】

⭐The brain and spinal cord are surrounded by the ventricular system, which looks like a flat balloon with a particular shape that surrounds the brain and spinal cord. The ventricular system is divided into parts called cerebral ventricles, which contain a fluid called cerebrospinal fluid. In normal pressure hydrocephalus (PNH), the cerebrospinal fluid does not drain properly. This can result in difficulty walking (usually with legs farther apart than usual), slowed thinking or impaired memory, and loss of urinary control.

⭐A physical examination and brain imaging such as magnetic resonance imaging are generally necessary for diagnosis.

⭐Treatment often involves surgery where a ventriculoperitoneal shunt system is placed to help drain excess fluid. This system is a device that, through very thin tubes under the skin, joins the cerebral ventricles with the peritoneum, a bag similar to the ventricular system but that surrounds the intestines in the belly.

【Lewy Body Dementia】

⭐Dementia with Lewy bodies is a progressive and neurodegenerative disorder in which an accumulation of abnormal deposits of a protein called alpha-synuclein in multiple areas of the brain is classically described.

⭐One of the first signs of this condition is progressive problems with memory, as well as the ability to understand instructions and perform certain tasks. Mental acuity and attention levels often fluctuate throughout the day. Recurrent visual hallucinations are common. These symptoms are later added to by a progressive decrease in the speed and range of movement, rigidity, and other PD-like symptoms.

⭐While the same aggregated form of the protein alpha-synuclein is found in the brains of those with PD, when people with PD develop memory and thinking problems, this tends to occur later in the course of their disease. than in dementia with Lewy bodies.

⭐Dementia with Lewy bodies is also a clinical diagnosis. There is no specific treatment for this condition. Your doctor can treat your memory problems and hallucinations with pills and try carbidopa-levodopa for the symptoms of parkinsonism, although these medications are generally less effective for motor symptoms than in treating Parkinson's. Treatment focuses on managing symptoms and correcting other factors that may influence them (for example, insomnia, depression, low blood pressure, or encouraging physical activity).

【Multiple system atrophy】

⭐Multiple system atrophy (MSA) may look like PD, but comes with additional symptoms and signs. It is also a progressive neurodegenerative disorder that has classically been associated with the abnormal accumulation of deposits of the protein alpha-synuclein.

⭐In addition to parkinsonism, symptoms include early-onset lack of coordination (ataxia) and dysfunction of the autonomic nervous system (dysautonomia). Dysautonomia can lead to urinary symptoms (urinary urgency or needing to go to the bathroom several times a night), erectile dysfunction, low blood pressure, feeling dizzy when standing, and decreased sweating.

⭐The diagnosis is made based on the symptoms. There is no specific test that provides a definitive diagnosis, although there are characteristic changes that can be seen on MRI of the brain in some patients.

⭐There is no specific treatment for MSA. Your doctor can treat your ataxia problems with physical therapy or with some pills, he can help your symptoms of dysautonomia with pills or some recommendations about your diet in the case of low blood pressure and try carbidopa-levodopa for the symptoms of parkinsonism, although these Medications are generally less effective for motor symptoms than in treating Parkinson's. Treatment focuses on managing symptoms and correcting other factors that may influence them, with the same idea presented above for dementia with Lewy bodies.

【Corticobasal syndrome】

⭐Corticobasal syndrome (CBS) is a progressive and very rare neurodegenerative disorder. It usually begins with symptoms affecting a limb, including pain, abnormal posture of a limb (dystonia), and sometimes the feeling that the limb “has a mind of its own.”

⭐In addition to parkinsonism, other symptoms may include jerky movements (myoclonus), difficulty with some motor tasks despite having normal muscle strength (apraxia), difficulty with language (aphasia), among others.

⭐The diagnosis is made based on the symptoms. There is no specific test that provides a definitive diagnosis, although there are changes that can be seen on MRI of the brain in some patients.

⭐There is no specific treatment for SCB. Your doctor may try carbidopa-levodopa for parkinsonism symptoms, although these medications are less likely to be effective, as they are in treating Parkinson's. Botulinum toxin (Botox) can be used to help with pain and abnormal posture of the extremities. Treatment focuses on managing symptoms and correcting other factors that may influence them, as mentioned above.

【Progressive Supranuclear Palsy】

⭐Progressive supranuclear palsy (PSP) is a disease that mimics PD, particularly in its early stages, but comes with additional distinctive signs and symptoms. It is a progressive neurodegenerative disorder.

⭐People with PSP may fall frequently in the early stages of the disease. Later symptoms include limitations in eye movement, particularly in looking up and down, which also contributes to falls.
Those with PSP also often have problems with swallowing (dysphagia), difficulty articulating words (dysarthria), sleep problems, and thinking problems.

⭐The diagnosis is made based on the symptoms. There is no specific test that provides a definitive diagnosis, although there are changes that can be seen on MRI of the brain in some patients.

⭐There is no specific treatment for PSP. Your doctor may refer you to physical therapy, occupational therapy, and rehabilitation to improve your motor symptoms and speech and swallowing therapy. Your doctor may also try carbidopa-levodopa for symptoms of parkinsonism, although these medications are generally less effective for motor symptoms than in treating Parkinson's. Treatment focuses on managing symptoms and correcting other factors that may influence them.