Movement Disorder Specialists   -

Pasadena, CA

About Parkinson's Plus Syndromes


Parkinson's Plus Syndromes are also known as Secondary and Atypical Parkinsonism.

Parkinson-plus syndromes respond poorly to the standard treatments for Parkinson’s disease. An inadequate response to treatment in a patient with parkinsonian symptoms suggests the possibility of a Parkinson-plus syndrome and warrants a search for the signs and symptoms of degeneration in other neuronal systems. Other clinical clues suggestive of Parkinson-plus syndromes include early onset of dementia, early onset of postural instability, early onset of hallucinations or psychosis with low doses of levodopa/carbidopa or dopamine agonists, ocular signs, such as impaired vertical gaze, blinking on saccade, square-wave jerks, nystagmus, blepharospasm, and apraxia of eyelid opening or closure.

Parkinson-plus syndromes respond poorly to the standard treatments for Parkinson disease. An inadequate response to treatment in a patient with parkinsonian symptoms suggests the possibility of a Parkinson-plus syndrome and warrants a search for the signs and symptoms of degeneration in other neuronal systems. Other clinical clues suggestive of Parkinson-plus syndromes include early onset of dementia, early onset of postural instability, early onset of hallucinations or psychosis with low doses of levodopa/carbidopa or dopamine agonists, ocular signs, such as impaired vertical gaze, blinking on saccade, square-wave jerks, nystagmus, blepharospasm, and apraxia of eyelid opening or closure.

Syndromes
Progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticalbasilar ganglionic degeneration, and frontotemporal dementia with parkinsonism (FTD-17).

Educational Websites & Organizations


Lewy Body Dementia Association
The Lewy Body Dementia Association (LBDA) is a nonprofit organization dedicated to raising awareness of the Lewy body dementias (LBD), supporting patients—including their families and caregivers—and promoting scientific advances. The association's purposes are charitable, educational, and scientific outreach. They currently are supporting scientists who are searching for a cure of Lewy body dementias.

Corticobasal Degeneration and Frontotemporal Degeneration
The Association for Frontotemporal Degeneration is a not-for-profit organization that advocates for more funding into the causes and treatments for frontotemporal degeneration as well as to provide caregivers and patients with a central place to find information and support. These diseases are more prevalent than was originally thought and the limited information and support available for caregivers and families, along with the lack of funding for research, inspired a group of dedicated caregivers, clinicians, and researchers to create an organization to address these unmet needs.

23 and Me - Genetics of Supranuclear Palsy
Progressive supranuclear palsy is a neurological disorder that results from deterioration of cells in parts of the brain that control body movement. Symptoms include loss of balance while walking, inability to aim the eyes and make eye contact, stiffness, awkward movements, problems with speech and swallowing, and other non-movement issues such as irritability, apathy, anxiety, laughing or crying for no reason, and forgetfulness. One in every 100,000 adults in the United States is affected by progressive supranuclear palsy. The disease usually strikes after age 60, but it can start as early as 40. There is no effective treatment for progressive supranuclear palsy, and the cause is unknown. Research has suggested viral infection, chemical exposures, free radical damage, and genetic mutations as possible candidates. Learn about the genes responsible for suprenuclear palsy and determine whether you are at risk for the disorder.

PSP Association
The Progressive Supranuclear Palsy (PSP) Association is a UK-based organization dedicated to the support of people with PSP and Cortico Basal Degeneration (CBD) by promoting research on the cause, treatment, and cure as well as providing informative resources and encouraging awareness. The PSP Association began as a charity in 1994 and has continued to support those with PSP and CBD ever since.

Symptoms

  • Tremor
  • Rigidity
  • Akinesia/bradykinesia
  • Postural instability
  • Early onset of dementia
  • Early onset of postural instability
  • Early onset of hallucinations or psychosis with low doses of levodopa/carbidopa or dopamine agonists
  • Ocular signs, such as impaired vertical gaze, blinking on saccade, square-wave jerks, nystagmus, blepharospasm, and apraxia of eyelid opening or closure
  • Pyramidal tract signs not explained by previous stroke or spinal cord lesions
  • Autonomic symptoms such as postural hypotension and incontinence early in the course of the disease
  • Prominent motor apraxia
  • Alien-limb phenomenon
  • Marked symmetry of signs in early stages of the disease
  • Truncal symptoms more prominent than appendicular symptoms
  • Absence of structural etiology such as a normal-pressure hydrocephalus (NPH)
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