Parkinsonism
Alerts and Notices
Synopsis
Parkinsonism can also result from medications (drug-induced parkinsonism), especially the dopamine receptor blocking agents such as the antipsychotics and antiemetics. It can result from certain toxins (such as carbon monoxide and organic solvents) as well as metabolic abnormalities (hypoparathyroidism). Structural injuries – chronic repetitive head trauma, hydrocephalus, subcortical small vessel ischemic vasculopathy ("vascular parkinsonism") – can also produce parkinsonism.
Thus the prognosis is variable, from static to progressive, depending on the etiology. Other symptoms and signs along with predisposing medical history and risk factors can yield valuable clues to the etiology.
Related topics: Drug-induced movement disorders
Codes
ICD10CM:G21.9 – Secondary parkinsonism, unspecified
SNOMEDCT:
32798002 – Parkinsonism
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Essential tremor – tremor typically worse with action and sustained posture
- Frontotemporal dementia – decreased executive function
- Alzheimer disease – memory is disproportionately affected
- Huntington disease
- Wilson disease
- Neurodegeneration with brain iron accumulation
- Neuroacanthocytosis
- Dystonia (eg, drug induced)
- Stiff person syndrome – often painful
- Depression – sad affect and mood
- Primary lateral sclerosis
- Hypothyroidism
- Polymyalgia
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/05/2017
Last Updated:02/06/2020
Last Updated:02/06/2020