Parkinson plus syndrome

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Parkinson-plus syndromes are a group of diseases featuring the classical features of Parkinson's disease (tremor; rigidity; akinesia/bradykinesia; postural instability) with additional features that distinguish them from simple idiopathic Parkinson's disease.

The Parkinson-plus syndromes and their additional features are:

• Multiple system atrophy (MSA)
  • cerebellar ataxia
  • pyramidal weakness
  • autonomic failure (previously known as Shy-Drager syndrome)
  • nocturnal stridor
• Progressive supranuclear palsy (PSP)
  • supranuclear palsy of eye movements (failure of voluntary vertical eye movements, especially downward gazing)
  • pseudobulbar palsy
  • dementia
• Corticobasal degeneration (CBD)
  • cognitive impairment, often including some form of aphasia and/or apraxia, and eventually developing to a full dementia
  • myoclonus
• Dementia with Lewy bodies (DLB)
  • early cognitive impairment
  • hallucinations
• Olivopontocerebellar atrophy (OPCA)
  • ataxia
  • dysarthria

It is said by neurologists that patients presenting with falls early in the course of a Parkinsonian illness are more likely to have a Parkinson-plus syndrome than idiopathic Parkinson's disease.

The Parkinson-plus syndromes are usually more rapidly progressive and less likely to respond to anti-parkinsonian medication than Parkinson's disease. However, the additional features of the diseases may respond to medications not used in Parkinson's disease.