Secondary Parkinsonism refers to different conditions that can cause movement symptoms similar to those associated with Parkinson’s disease. These include tremor, slowed movements, and stiffness.

A person can develop secondary Parkinsonism from a variety of different causes. These can include adverse reactions to medications, neurodegenerative disorders, and brain damage, among others.

This article reviews what secondary Parkinsonism is, how it compares with Parkinson’s disease, potential causes, and more.

The hand of a person with secondary parkinsonism.Share on Pinterest
Stefan Wasner/EyeEm/ Getty Images

Parkinsonism is an umbrella term. It covers several different conditions that can cause movement problems similar to those seen in Parkinson’s disease, such as tremors, stiffness, and slowed movements.

Secondary Parkinsonism can develop as a result of several potential causes. The most common cause is a reaction to, or side effect of, specific medications such as calcium channel blockers or neuroleptics.

Parkinson’s UK states that Parkinson’s disease is a type of Parkinsonism.

Parkinson’s disease is a neurodegenerative condition with a well-defined cause and symptoms. Secondary Parkinsonism develops as a result of medication side effects, brain damage, or neurodegenerative diseases.

According to the American Association of Neurological Surgeons, Parkinson’s disease affects the nerve cells in the substantia nigra, which is the part of the brain that controls movement.

As these nerve cells become impaired or die, they lose the ability to produce dopamine. Dopamine works with other neurotransmitters to allow for regular movement. Without enough dopamine, a person’s balance is disrupted, resulting in movement issues, stiffness, and tremor.

In addition to motor issues, a person can develop other symptoms, including depression, cognitive changes, and gastrointestinal issues.

Treatments can overlap between the two conditions. However, medications are not as effective for treating secondary Parkinsonism.

The most common cause of secondary Parkinsonism is a reaction to medications that have certain effects on the nervous system.

A 2022 article states that some common types of medications that may cause the condition include:

  • first-generation antipsychotics, including:
    • fluphenazine
    • haloperidol
    • trifluoperazine
  • second-generation antipsychotics, including:
    • risperidone
    • ziprasidone
    • olanzapine
  • antiemetic agents and prokinetic medications, including:
    • metoclopramide
    • domperidone
    • levosulpiride
    • prochlorperazine
  • dopamine-depleting drugs, including:
    • tetrabenazine
    • reserpine
  • other medications, including:

Medical conditions also cause secondary Parkinsonism, including:

  • normal-pressure hydrocephalus, which is an abnormal buildup of spinal fluid in the brain
  • brain damage due to a vascular event, such as a stroke or bleed
  • repeated head injury
  • prolonged exposure to heavy metals and industrial toxins, such as manganese or iron
  • a brain tumor
  • hypoxia, or low oxygen levels in the body tissues

Some viral infections have an association with brain damage that could cause secondary Parkinsonism. These include:

Symptoms of secondary Parkinsonism are similar to those of Parkinson’s disease. They can include:

  • tremor
  • slow movement
  • decrease in facial expressions
  • trouble starting and controlling movement
  • soft voice
  • stiffness of the arms, legs, or trunk
  • memory loss
  • confusion

A person may also experience symptoms related to an underlying condition that may be causing secondary Parkinsonism.

There is no specific test for diagnosing secondary Parkinsonism. However, testing can help a doctor determine the underlying cause.

A doctor may:

  • perform a physical examination
  • review a person’s family history
  • review a person’s medical history
  • ask about symptoms

A doctor may perform imaging tests, such as a CT or MRI scan, to check for vascular lesions, brain tumors, or other abnormalities.

They may also suggest a dopamine transporter scan. This allows them to check the function of the dopamine transporters in a person’s brain.

A doctor will also have to rule out atypical Parkinsonism. Atypical Parkinsonism includes syndromes that are similar to Parkinson’s disease, such as progressive supranuclear palsy and dementia with Lewy bodies.

They may order blood tests to help rule out other causes of symptoms. They may also order genetic testing.

Treatment for secondary Parkinsonism will vary based on the underlying cause of the condition.

If medication is the cause, a doctor will likely recommend stopping the medication or replacing it with another. They may prescribe anticholinergic medications, such as benztropine and trihexyphenidyl, to treat drug-induced Parkinsonism.

A doctor may also prescribe medications that treat Parkinson’s disease, such as levodopa or carbidopa.

In rare cases, they may recommend electroconvulsive therapy.

Treatments for other causes of secondary Parkinsonism involve treating the underlying condition. In some cases, treatments, such as the removal of a brain tumor, may lead to a reduction in symptoms.

Doctors may also recommend:

A person’s overall outlook will depend on:

  • the underlying cause of the condition
  • their age
  • onset of symptoms
  • how well the administered treatments work for them

In some cases, a person may find that treatment causes their symptoms to stabilize or stop entirely.

Secondary Parkinsonism is associated with several potential complications. These can include:

  • fall-related injuries
  • difficulty completing daily tasks
  • varying degrees of disability
  • medication side effects

A person should contact a doctor if they experience symptoms related to secondary Parkinsonism.

A doctor will diagnose any underlying causes and provide treatment options.

Not all cases of secondary Parkinsonism are preventable.

To avoid repeated head injuries, people can avoid taking part in contact sports or wear a helmet when there is a risk of head injury.

Secondary Parkinsonism is a condition that causes tremor, muscle movement issues, and other symptoms commonly associated with Parkinson’s disease.

Secondary Parkinsonism can occur due to a variety of potential underlying causes. The most common is a reaction to certain medications.

Treatment typically involves addressing the underlying condition. After receiving treatment, a person may find that their symptoms ease, and in some cases, symptoms may disappear.