Main Difference – Parkinsonism vs Parkinson’s Disease
Parkinsonism and Parkinson’s disease are two medical conditions that occur due to the unusual functioning of brain processes and it is quite confusing to identify the line of demarcation which differentiates one from the other. However, health care professionals tend to observe various clinical features, findings on physical examination and investigations, in order to establish an accurate diagnosis, for the purpose of treatment and follow-ups. The main difference between Parkinsonism and Parkinson’s disease is that Parkinsonism is a comparatively rapidly progressive condition than Parkinson’s disease with additional features like hallucinations, delusions, and dementia.
Here, we will discuss,
1. What is Parkinsonism – Clinical Features, Cause, Method of Treatment
2. What is Parkinson’s Disease – Clinical Features, Cause, Method of Treatment
3. Difference Between Parkinsonism and Parkinson’s disease
What is Parkinsonism | Definition, Clinical Features, Cause, Method of Treatment
Parkinsonism is defined as a syndrome which is characterized by a combination of Bradykinesia (slowing with degradation of repetitive movements), stiffness and tremors. Even though subtle tremors and bradykinesic movements can be commonly seen among elderly people, features in Parkinsonism tend to be non-specific and exaggerated.
As far as the etiology of this condition is concerned, Parkinson’s disease is so far the commonest neurodegenerative cause (80% of affected cases) where multiple system atrophy, progressive supra-nuclear palsy, and cortico-basal degeneration are also known to play important roles and therefore referred to as Atypical parkinsonism or Parkinson-plus syndromes.
These Atypical Parkinsonism syndromes have a worse prognosis compared to that of the typical one since they do not respond well to dopaminergic medications.
Symptomatic Parkinsonism can also occur due to various secondary causes such as vascular conditions, drugs, infections, toxic agents and structural anomalies of central nervous system. Drug-induced Parkinsonism is known to be the commonest condition of all types and is caused by various antipsychotics, anti-emetics and sodium valproate. Vascular Parkinsonism,also known as arteriosclerotic pseudo-Parkinsonism, is characterized by an emphasized lower body, disturbances in gait and concomitant impairment of cognition.
Even though there is no clear cut method of diagnosis for Parkinsonism, revealing the possible etiology plays a very important role in treating Parkinsonism. If it is caused by drugs, the dosage should either be altered or replaced with an alternative with fewer side effects. Additionally, lifestyle modifications such as regular exercises, physical and occupational therapy, prevention from falls should be taken into consideration while taking care of affected individuals.
What is Parkinson’s Disease | Definition, Clinical Features, Cause, Method of Treatment
Being the commonest neurodegenerative cause of Parkinsonism, Parkinson’s disease is defined as a clinical syndrome characterized by lesions in the basal ganglia which mainly involves the degeneration of Neuro melanin-containing neurons in the brainstem particularly in the region of Substantia Nigra.
The root cause of Parkinson’s disease is identified to be multifactorial with the involvement of factors such as heredity, positive family history, environmental toxins, and advanced age. This condition usually occurs between the ages of 40-70 with a peak incidence in the seventh decade of life.
The major clinical picture of this condition includes resting tremors, rigidity, stiffness, Akinesia and dysfunctional postural reflexes and all these symptoms and signs are known to be gradually worsening over time. Other non-motor features may include depression, loss of smell, gastric disturbances, and cognitive changes.
A definitive diagnosis of Parkinson’s disease can be made only at an autopsy by the identification of the presence of degenerative changes in the brain stem and Lewy bodies predominantly in Substantia nigra.
Even though there is no permanent cure for Parkinson’s disease, symptoms can be improved with various medical and surgical interventions.
The most popular medications used in affected individuals include dopamine agonists, inhibitors of catechol-0-menthyltransferase (COMT) and monoamine oxidase type B (MAO-B) inhibitors whereas major surgical interventions available include Pallidotomy, chronic deep-brain stimulation (DBS) of the subthalamic nucleus (STN) and Globus Pallidus Internus using an implantable pulse generator (IPG).
Difference Between Parkinsonism and Parkinson’s Disease
Definition
Parkinsonism: Parkinsonism is a syndrome characterized by a combination of Bradykinesia, stiffness, and tremors.
Parkinson’s Disease: Parkinson’s disease is a clinical syndrome characterized by lesions in the basal ganglia.
Clinical Features
Parkinsonism: Parkinsonism is a comparatively rapidly progressive condition than Parkinson’s disease with additional features like hallucinations, delusions, and dementia.
Parkinson’s Disease: Major clinical features of Parkinson’s disease include resting tremors, rigidity, stiffness, Akinesia and dysfunctional postural reflexes, depression, loss of smell, gastric disturbances, and cognitive changes.
Causes
Parkinsonism: More than 80% of the identified cases are due to Parkinson’s disease. The secondary causes include vascular conditions, drugs, infections, toxic agents and structural anomalies of central nervous system.
Parkinson’s Disease: The root cause is multifactorial such as heredity, positive family history, environmental toxins, and advanced age.
Response to Treatment
Parkinsonism: Parkinsonism is known to be taking a longer duration to respond or do not respond at all to the treatment with Levodopa (Dopaminergic therapy)
Parkinson’s disease: Parkinson’s disease may respond faster to treatment since it is less progressive that parkinsonism.
Image Courtesy:
“Sir William Richard Gowers Parkinson Disease sketch 1886” (Public Domain) via Commons Wikimedia
“Blausen 0704 ParkinsonsDisease” By Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. – Own work, (CC BY 3.0) via Commons Wikimedia
