If you have it you have it but what exactly is it that you have. Snowflakes, no two alike, all different. Is Parkinson’s one disease or many and what is the difference between Parkinson’s and Parkinsonism?
Parkinson’s disease is a neurodegenerative brain disorder that affects dopamine producing neurons in the area of the brain called the substantia nigra. Dopamine is a neurotransmitter, a chemical that transmits signals between brain and nerve cells. It is partially responsible for making controlled movements in the body. Symptoms usually develop slowly over years and may differ from one person to another. The main physical symptoms are tremors, stiffness, slow movement, balance problems, and postural instability. A PWP may also experience a wide range of non-motor symptoms such as depression, fatigue, sleep disorders, mood disorders, sexual dysfunction, constipation, loss of smell, gastric problems, cognitive changes, and on and on. Symptoms usually develop slowly over a number of years and often don’t appear until 80% of your dopamine producing neurons are gone. You may have PD for years without knowing it.
Parkinsonism means looks like Parkinson’s. Parkinsonism refers to a group of neurological disorders, not all of which have been clearly defined or named, that cause movement problems similar to PD. A person who has Parkinsonism will also have another underlying disorder that causes additional neurological symptoms such as dementia. Dementia with Lewy Bodies is second only to Alzheimer’s as the most common cause of dementia in the elderly.
Several Parkinsonism symptoms are similar to PD symptoms: flexed posture, slow movement, stiffness and rigidity, small steps without arm swing, and problems with balance. It is called atypical Parkinson’s because it differs from PD in a few ways: there is often no tremor, both sides of the body are usually affected equally, levodopa and other PD meds and DBS may not work. People with Parkinsonism not only have problems producing dopamine but also have damaged or destroyed receptor cells that do not respond to dopamine. With Parkinson’s the dopamine producing neurons are depleted. With Parkinsonism both dopamine producing and receptor cells are damaged. Parkinsonism develops quickly while PD is usually slower although PD progresses faster the older you are. Parkinsonism treatment is determined by the plus disease.
There is no definitive test to detect Parkinson’s disease or Parkinsonism. A DatScan doesn’t differentiate because Parkinsonism has a loss of dopamine as does PD. So if Parkinson’s and Parkinsonism look, smell, and taste alike how do you tell them apart? Doctors say that they depend on a thorough medical history and a number of different movement tests but that is not completely true. The real test is if you respond positively to a dopamine drug it is diagnosed as PD, if not it is diagnosed as Parkinsonism because your receptors cells are damaged as well.
What do you have? If you find this confusing you are not alone. Parkinson’s is often confused with Parkinsonism and they are sometimes misdiagnosed. One study estimated that doctors fail to diagnose or misdiagnose PD and Parkinsonism 35% of the time. What we do know is that a regular daily exercise program benefits both PD and Parkinsonism and may help slow the progression of the disease. Exercise is also important for maintaining muscle tone, strength, flexibility, and overall health. Both PD and Parkinsonism have no cure so doctors try to treat the symptoms that most affect each person’s quality of life. The diagnosis and treatment may need to be revised over time based on speed of disease progression, response to medications and other factors.
