Several conditions fall into the category of Parkinson-like diseases. They can mimic Parkinson’s symptoms, such as tremors, slow movements, and stiffness.
Examples of conditions similar to Parkinson’s include dementia with Lewy bodies, multiple system atrophy, and progressive supranuclear palsy.
While these conditions mimic Parkinson’s disease, each one has distinguishing features that can lead doctors to a correct diagnosis. The conditions may differ in the order in which symptoms appear or in the additional symptoms they cause that do not link to Parkinson’s disease.
Some of the conditions have no specific treatment, but doctors may prescribe a combination of medications, such as carbidopa and levodopa (Sinemet), the main treatment for Parkinson’s disease.
This article will explain which conditions can mimic Parkinson’s disease, as well as the symptoms, diagnosis, and treatment of Parkinson’s disease.
Several conditions can manifest one or more of the main symptoms of Parkinson’s disease. Those listed below are the most common:
Dementia with Lewy bodies (DLB)
DLB is a progressive neurodegenerative condition that
The first manifestation of DLB is worsening problems with thinking and memory. Other symptoms include recurring visual hallucinations and fluctuating alertness during the day. As the condition progresses, symptoms similar to those of Parkinson’s disease, such as stiffness and slow movement, appear.
DLB has no specific treatment. Doctors may prescribe the main treatment for Parkinson’s disease, although it is less likely to be effective.
Read more about Parkinson’s disease, Lewy bodies, and dementia.
Progressive supranuclear palsy (PSP)
PSP is an advancing neurodegenerative disorder. Early in its course, it can resemble Parkinson’s disease. One of the earliest symptoms is frequent falling. As PSP advances, people experience eye movement limitations, which contribute to falls.
Other possible symptoms include:
- difficulties with speech and swallowing
- difficulty with thinking
- poor sleep
PSP has no specific treatment. Doctors may prescribe the main treatment for Parkinson’s disease, although it is less likely to be effective.
Multiple system atrophy (MSA)
MSA is another progressive neurodegenerative condition that doctors believe stems from abnormal alpha-synuclein protein. In addition to symptoms similar to those of Parkinson’s disease, it can cause symptoms such as:
- problems with coordination
- erectile dysfunction
- changes in sweating
- lightheadedness when standing
- urinary symptoms, including:
- frequency
- urgency
- multiple urinations at night
MSA has no specific treatment. Doctors may prescribe the main treatment for Parkinson’s disease, although it is less likely to be effective.
Normal pressure hydrocephalus (NPH)
NPH involves improper drainage of the cerebral spinal fluid, which surrounds the brain and spinal cord. This can lead to:
- slowed thinking
- difficulty walking
- loss of bladder control
Treatment may involve the surgical placement of a shunt to drain excess fluid.
Read more about hydrocephalus here.
Corticobasal syndrome (CBS)
CBS is a rare neurodegenerative disorder that typically starts with symptoms in one limb. These may include:
- unusual posturing of a limb
- pain
- a feeling that a limb has a mind of its own
In addition to Parkinson’s disease symptoms, manifestations of CBS may include:
- difficulty with some movements despite standard muscle strength
- jerky, fast movements
- difficulty with language
CBS has no specific treatment. Doctors may prescribe the main treatment for Parkinson’s disease, although it is less likely to be effective. Botulinum toxin (Botox) may decrease pain and unusual posturing of limbs.
Post-traumatic parkinsonism
Traumatic head injuries increase the risk of Parkinson’s disease, an effect called post-traumatic parkinsonism.
When a person sustains a traumatic head injury, they experience immediate effects as well as secondary effects, which develop over a period of time. Secondary effects are an important factor in triggering symptoms of Parkinson’s disease, according to a 2022 review.
Researchers are exploring treatments that can help protect against or reduce secondary effects during recovery from traumatic brain injury.
Essential tremor
Essential tremor occurs in the forearms and hands when the limbs are active. This differs from the tremors of Parkinson’s disease, which typically happen while a person is at rest and start in one limb.
Essential tremor usually affects both sides of the body and often affects the voice or head as well. While it can start in childhood or early adulthood, the incidence increases with age.
Treatment usually entails medications or, in severe cases, surgery.
Doctors will base a diagnosis on a person’s symptoms, including the order in which they appear. Some conditions that resemble Parkinson’s disease cause unrelated symptoms in the early stage and do not produce Parkinson-like symptoms until they have progressed.
Other conditions manifest Parkinson-like symptoms early but also cause other symptoms that are not typical of Parkinson’s disease.
Diagnosing NPH involves medical tests in addition to an assessment of symptoms. Because NPH is due to poor drainage of cerebral spinal fluid, other diagnostic tools are necessary. These may include:
- physical examination
- lumbar puncture, or spinal tap, which involves the removal of a sample of cerebral spinal fluid
- specialized brain scans
Additionally, response to drug treatment
Parkinson’s disease has four
- muscle stiffness, in which a muscle remains contracted for a long time
- a tremor in the arms, hands, jaw, legs, or head
- problems with coordination and balance, sometimes leading to falls
- slow movements
Other possible symptoms include:
- trouble chewing, swallowing, and speaking
- skin problems
- depression and other emotional changes
- constipation or urinary problems
No lab or blood tests are available to diagnose non-genetic cases of Parkinson’s disease. Diagnosis
When drug treatment results in improvements, it is also an indication of Parkinson’s disease.
Learn more about how doctors diagnose Parkinson’s disease here.
While Parkinson’s disease
Medications
Medications help by:
- increasing the level of the neurotransmitter dopamine in the brain
- changing the levels of other brain chemicals
- helping to reduce non-movement symptoms
The main treatment is levodopa. Nerve cells use it to replenish the brain’s reduced supply of dopamine, which is the cause of the movement symptoms of Parkinson’s disease. Typically, individuals take levodopa with carbidopa, which prevents some of the side effects, such as:
- low blood pressure
- nausea and vomiting
- restlessness
The combination of carbidopa and levodopa sells under the brand name Sinemet.
Other medications may include:
- dopamine agonists, such as pramipexole (Mirapex), which trigger the production of dopamine in the brain
- amantadine (Gocovri) to decrease involuntary movements
- various classes of enzyme inhibitors, which slow enzymes that break down dopamine
- anticholinergic drugs, such as trihexyphenidyl (Artane), which decrease tremors and muscle rigidity by blocking acetylcholine, a brain chemical involved in movement
Deep brain stimulation
Deep brain stimulation is an option if the disease does not respond well to medications.
This surgical procedure involves implanting electrodes into the brain and connecting them to an electrical device that stimulates parts of the brain. This may alleviate movement-related symptoms such as tremors and rigidity.
Other therapies
Other possible ways to manage Parkinson’s disease symptoms include:
- a nutritious diet to promote general wellness
- physical, occupational, and speech therapy, which may decrease gait and voice problems
- exercise to increase balance, strength, and flexibility
- tai chi to boost flexibility
- massage therapy to decrease tension
An array of conditions manifest Parkinson-like disease symptoms, such as tremors, slow movements, and stiffness.
However, these conditions have differences from Parkinson’s disease. Doctors may sometimes diagnose these conditions based on the symptoms alone. One exception is NPH — diagnosing this condition may require medical tests such as a brain scan and lumbar puncture.
Treatment of these conditions may involve the main treatment for Parkinson’s disease, which is a combination of the medications carbidopa and levodopa. However, it is not likely to work as effectively.
If a person has Parkinson’s disease rather than a Parkinson-like disease, other treatment options are available in addition to medications.