Secondary parkinsonism Health Article

Definition

Secondary parkinsonism is similar to Parkinson's disease, but it is caused by certain medicines, a different nervous system disorder, or another illness.

Alternative Names

Parkinsonism - secondary

Causes, incidence, and risk factors

Parkinson's disease is one of the most common nervous system (neurologic) disorders of the elderly. "Parkinsonism" refers to any condition that causes Parkinson's-type abnormal movements. These movements are caused by changes in or destruction of the nerve cells (neurons) that produce the chemical dopamine in a certain area of the brain.

Secondary parkinsonism may be caused by disorders such as:

• Encephalitis
• Meningitis
• Stroke

Other disorders can also damage the dopamine neurons and produce this condition, including:

• Corticobasal degeneration
• Diffuse Lewy body disease
• Multiple system atrophy
• Progressive supranuclear palsy

Another common cause of secondary parkinsonism is medication, such as:

• Antipsychotics (haloperidol)
• Metoclopramide
• Phenothiazine medications

If they damage the area of the brain that contains the dopamine neurons, the following may cause secondary parkinsonism:

• Brain damage caused by anesthesia drugs (such as during surgery)
• Carbon monoxide poisoning
• Exposure to toxins
• Overdoses of narcotics

There have been cases of secondary parkinsonism among intravenous drug users who injected a substance called MPTP, which can be produced when making a form of heroin. These cases are rare and have mostly affected long-term drug users.

Secondary parkinsonism caused by antipsychotics or other medications is usually reversible if identified soon enough. However, it may not be reversible if it is caused by:

• Drug-related brain damage
• Infections
• Toxins

Symptoms

Symptoms of parkinsonism may include:

• Decrease in facial expressions
• Difficulty controlling movement
• Soft voice
• Some types of paralysis
• Stiffness of the trunk, arms, or legs
• Tremor

Although cognitive problems are not as common in Parkinson's disease, they may be more likely in secondary parkinsonism. This is because the diseases that cause secondary parkinsonism often lead to dementia.

For a more detailed description of symptoms, see Parkinson's disease.