There are several neurological conditions which are described as ‘atypical Parkinsonism’ which may be grouped under the term Parkinson’s Plus. These include:
- Progressive Supranuclear Palsy (PSP)
- Multi-System Atrophy (MSA)
- Cortical Basal Degeneration (CBD)
- Lewy Body Disease (DLB)
The Parkinson’s Plus information sheet provides more information on these conditions.
Of the above, Cortico-Basal Degeneration is the least frequently encountered. All conditions are not thought to be hereditary, are diagnosed most often in the middle years of life (50s-60s)
and occur equally in both men and women. These conditions are referred to as Parkinson’s Plus because they each share similarities with Parkinson’s. People with these conditions are likely to experience Parkinsonism – that is the slowness and stiffness traditionally associated with Parkinson’s. Tremor may also be a feature.
However, there are additional features which distinguish them from Idiopathic Parkinson’s. Unfortunately, Parkinson’s Plus conditions progress more quickly than Idiopathic Parkinson’s. There may be early and frequent falls, early difficulty with speech and swallowing, impaired blood pressure control, urinary incontinence and bowel problems, plus cognitive difficulties. It can be difficult to differentiate between the Parkinson’s Plus conditions, therefore it is extremely important to seek out a specialist who has experience in dealing with these rare conditions to
ensure the correct diagnosis, best care and appropriate support is received. He or she will be on the lookout for symmetrical (both sides of the body) symptoms (Parkinson’s has a unilateral onset), lack of tremor and a lack of response to Levodopa. These features can provide clues to your doctor and help him or her make the diagnosis. As with Parkinson’s the diagnosis of Parkinson’s Plus is made through the taking of a detailed clinical history and neurological examination. In some cases the treating specialist may suggest a special scan of the heart called an MIGB scan. This test can help to differentiate between Lewy Body disease (Parkinson’s and Lewy Body Dementia) and the Parkinson’s Plus conditions. In other cases an MRI scan of the brain may be helpful in identifying characteristic signs of MSA or PSP. Some people with Parkinson’s Plus may gain partial benefit from the use of the drugs used to treat Parkinson’s, such as Levodopa. Regrettably, in many cases this response will not be sustained. The mainstay of treatment is supportive care and Allied Health input. The use of a physiotherapist, occupational therapist and speech pathologist can be invaluable in ensuring your quality of life is maximised and supported.
Progressive Supranulear Palsy PSP is a rare neurological condition affecting parts of the brain that control walking, eye movements, balance, speech and swallowing. The PSP Australia website provides lots of information on PSP, MSA and CBD
Visit the Alzheimers Australia website for more information on Lewy Body Disease DLB
Our Parkinson’s Nurse Specialists also see people with PSP so please feel free to call and make an appointment on (08) 6457 7373 or email firstname.lastname@example.org