Parkinson's-Plus Syndromes
These Conditions are Related to Parkinson's with Some Added Problems
Jun 30, 2007
Parkinson's disease is defined as the impairment or destruction of dopamine-producing cells in the brain. Lack of dopamine causes muscle rigidity, slowness, tremor, and balance problems. Parkinson's-plus syndromes cause the common Parkinson's symptoms, but these conditions also involve other parts of the nervous system, hence the name Parkinson's-"plus." Since other areas are involved, Parkinson's-plus syndromes may not respond completely to Parkinson' s disease medications (levodopa/carbidopa.) The plus syndromes also tend to progress more rapidly than regular Parkinson's disease. The following are four of the best-known Parkinson's-plus syndromes:
Progressive Supranuclear Palsy
This plus syndrome is drug-resistant. Its most unique characteristic is the inability of a patient to move his or her eyes up or down. Gazes can freeze upward, causing difficulty with walking downstairs, dressing, and many other tasks. PSP may cause a patient to have stiff muscles in the neck, adding to the inability to scan with the eyes.
Other characteristics of progressive supranuclear palsy include early loss of balance, speech and swallowing problems, as well as accompanying depression and cognitive issues.
Cortico-basal Ganglionic Degeneration
This plus syndrome involves the shrinking of the cortex of the brain. It presents with similar symptoms as Parkinson's disease: stiffness, balance issues, speaking problems, and cognitive degeneration. Tremor can be a symptom, but it is not as big of an issue as it in Parkinson's disease.
Problems specific to CBGD include symptoms (initially) only affecting one side of the body (asymmetry), body "jerking", limb apraxia or incoordination , and "alien limb" or movement of a particular limb without direction from the brain. Later issues with CBGD include depression and/or dementia. Again, cortico-basal ganglionic degeneration does not respond well to Parkinson's medications.
Multiple System Atrophy
This group of syndromes mimics pure Parkinson's disease, but eventually other specific symptoms develop that classify them as plus disorders. With multiple system atrophy, more than one group of nerve cells degenerate. In Parkinson's disease, dopamine-producing cells are affected, but with MSA, other cells are also impaired or destroyed. One of these syndromes presents like Parkinson's, but patients can exhibit extreme balance issues. Another MSA syndrome can very closely mimic Parkinson's, but it has almost no response to Parkinson's medications. A third MSA syndrome has additional autonomic dysfunctions. These functions are part of the autonomic nervous system, and they include blood pressure regulation, bladder control, sexual function, and breathing.
Dementia With Lewy Bodies
The last category of Parkinson's-plus disorders most gravely affects the mind. Parkinson's-like symptoms can occur, such as tremor, shuffling gait, and movement problems. Dementia with Lewy bodies causes abnormal protein deposits in the brain (Lewy bodies.) This syndrome resembles Parkinson's and Alzheimer's, because it causes dementia, depression, and hallucinations.
Unlike the other Parkinson's-plus syndromes, it seems that DLB progresses at a slow-to-steady rate, and Parkinson's and Alzheimer's medications may slow the progress of the disease.
For further reference:
http://www.parknicollet.com/methodist/parkinsons/parkinsons-disease/parkinsons-plus-disorders/index.cfm
http://www.cmdg.org/Movement_/Parkinsons_Plus/parkinsons_plus.htm
http://health.yahoo.com/ency/healthwise/ty7243
***For more information, read Parkinson's Disease and Coping and Muhammad Ali's Fight.
***For related neurological information, check out the Neurological ARTICLE INDEX and Blog.
********************************************************************************************************
