Conditions that Mimic Parkinson's

Parkinsonism is a term used to describe the collection of signs and physical symptoms. These include slowness (bradykinesia), stiffness (rigidity), and resting tremor. Conditions other than PD may have one or more of these symptoms, mimicking Parkinson’s. Listed below are the more common medical conditions that can present with Parkinsonism. There are additional causes of Parkinsonism (not listed below) that your doctor will assess you for.

- Essential tremor (ET) is a tremor involving the hands or forearms that occurs when the limbs are active. It typically involves both sides of the body. Often tremor is also present in the head or noted in the voice. This is different from the tremor in PD which usually starts in one limb and occurs at rest.
- The incidence of ET increases with age, although it can be present in childhood or early adulthood. There is often a family history of tremor, especially in those with younger ages of tremor onset.
- Like PD, the diagnosis of ET is clinical. Treatment is generally done using medications, though surgery can be used in severe cases.
- ET is thought to be a different condition from PD, though sometimes symptoms can overlap.
- Evidence suggests that those with ET may be at higher risk of developing PD than the general population.
- The fluid which surrounds the brain and spinal cord is known as cerebral spinal fluid. In Normal pressure hydrocephalus (NPH), the cerebral spinal fluid does not drain properly. This can result in difficulty walking, slowed thinking, and loss of bladder control.
- Specialized brain scans, lumbar puncture (spinal tap), and a physical examination can lead to a diagnosis.
- Treatment often involves surgery where a shunt is placed to help drain excess fluid.
- Dementia with Lewy bodies is a progressive, neurodegenerative disorder in which abnormal deposits of a protein called alpha-synuclein build up in multiple areas of the brain.
- One of the first signs of this condition is progressive problems with memory and thinking. Often levels of alertness and attentiveness fluctuate throughout the day. Recurrent visual hallucinations are common. These symptoms are joined later in the course of the disease by parkinsonism with slowness, stiffness and other symptoms similar to PD.
- While the same abnormal protein (alpha-synuclein) is found in the brains of those with PD, when individuals with PD develop memory and thinking problems it tends to occur later in the course of their disease than in dementia with Lewy bodies.
- Dementia with Lewy bodies is also a clinical diagnosis. There is no specific treatment for this condition. Your doctor may trial carbidopa levodopa for symptoms of parkinsonism, although these medications are less likely to be effective than they are in treatment of PD. Treatment focuses on alleviating symptoms.
- Multiple system atrophy (MSA) may resemble PD, but comes with additional symptoms and signs. It is also a progressive neurodegenerative disorder thought to be from abnormal alpha-synuclein protein.
- In addition to parkinsonism, symptoms include early onset incoordination (ataxia) and dysfunction in the autonomic nervous system (dysautonomia). Dysautonomia can result in urinary symptoms (urgency, frequency, need to use the bathroom multiple times at night), erectile dysfunction, feeling lightheaded when standing, and decrease in sweating.
- Diagnosis is made based on symptoms. There is no specific test that provides a definitive diagnosis, although there are changes that can be seen on MRI of the brain in some patients.
- There is no specific treatment for MSA. Your doctor may trial carbidopa levodopa for symptoms of Parkinsonism, although these medications are less likely to be effective than they are in treatment of PD. Treatment focuses on alleviating symptoms.
- Corticobasal syndrome (CBS) is rare, progressive neurodegenerative disorder. It usually begins with symptoms affecting one limb including pain, abnormal posturing of a limb (dystonia), and sometimes the feeling that the limb “has a mind of its own”.
- In addition to parkinsonism, other symptoms can include fast, jerky movements (myoclonus), difficulty with some motor tasks despite normal muscle strength (apraxia), difficulty with language (aphasia) among others.
- Diagnosis is made based on symptoms. There is no specific test that provides a definitive diagnosis, although there are changes that can be seen on MRI of the brain in some patients.
- There is no specific treatment for CBS. Your doctor may trial carbidopa levodopa for symptoms of Parkinsonism, although these medications are less likely to be effective than they are in treatment of PD. Botoulinum toxin (Botox) might be used to help with pain and abnormal posturing of limbs. Treatment focuses on alleviating symptoms.
- Progressive supranuclear palsy (PSP) is a disease that mimics PD, particularly early in its course, but that comes with additional distinctive signs and symptoms. It is a progressive, neurodegenerative disorder.
- Individuals with PSP may fall frequently early in the course of disease. Later symptoms include limitations in eye movements, particularly looking up and down, which also contributes to falls.
- Those with PSP also often have problems with swallowing (dysphagia), difficulty in producing speech (dysarthria), sleep problems and thinking problems.
- Diagnosis is made based on symptoms. There is no specific test that provides a definitive diagnosis, although there are changes that can be seen on MRI of the brain in some patients.
- There is no specific treatment for PSP. Your doctor may trial carbidopa levodopa for symptoms of Parkinsonism, although these medications are less likely to be effective than they are in treatment of PD. Treatment focuses on alleviating symptoms.

Page reviewed by Dr. Lauren Fanty, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

Essential Tremor

Normal Pressure Hydrocephalus

Dementia with Lewy Bodies

Multiple System Atrophy

Corticobasal Syndrome

Progressive Supranuclear Palsy

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