Central nervous system
Central nervous system


Secondary parkinsonism

Alternative Names:
Parkinsonism - secondary

Treatment:

Treatment is aimed controlling symptoms. If the symptoms are mild, no treatment may be required.

If the condition is caused by a medication, the benefits of the medication should be weighed against the severity of symptoms and stopped or changed if they seem counterproductive.

Treatment of underlying conditions (such as stroke, infections) can reduce symptoms.

Medications may be used if symptoms interfere with the ability to perform daily activities. The medication, or dose, timing or combination of medications may need to be adjusted as symptoms change.

Many of the medications used to treat this condition can cause severe side effects, so monitoring and follow up by the health care provider are important. Secondary parkinsonism tend to be less responsive to medical therapy than Parkinson's disease.

Medications include:

  • Amantadine or anticholinergic medications
  • Levodopa/carbidopa
  • Dopamine agonists
Additional medications include antihistamines, antidepressants, monoamine oxidase inhibitors or others to help reduce symptoms or control the side effects of primary treatment medications.

Good general nutrition and health are important. Exercise should continue, with the level of activity adjusted to meet the changing energy levels that may occur. Regular rest periods and avoidance of stress are recommended, because tiredness or stress can make symptoms worse.

Physical therapy, speech therapy and occupational therapy may help promote function and independence, and may help maintain skills and positive attitude and minimize depression.

Simple aids such as railings or banisters placed in commonly used areas of the house, special eating utensils or other devices may be of great benefit to the person experiencing some difficulties with daily living activities.

Social work or other counseling services may help in coping with the disorder, and obtaining assistance as appropriate (such as safety equipment, Meals-on-Wheels, volunteer services or other assistance).



Support Groups:
Emotional support may help in coping with the changes caused by the disease. This may include the National Parkinson's Foundation or other support groups (see Parkinson's disease - support group).

Expectations (prognosis):
The outcome varies and depends on the cause. If the disorder is caused by medications, it is potentially treatable. All other causes are not reversible and, to a greater or lesser degree, progressive.

Complications:


Calling your health care provider:
Call your health care provider if symptoms of secondary parkinsonism develop, recur, worsen or progress.

Call your health care provider if new symptoms appear in a person with this disorder, including possible side effects of medications: involuntary movements, nausea/vomiting, dizziness, changes in alertness/behavior/mood, severe confusion or disorientation, delusional behavior, hallucinations, loss of mental functions or any other new symptoms that develop (see also information on potential side effects of the specific medication).

Discuss the situation with your health care provider if you are unable to care for the person at home (after initial treatment).


Review Date: 7/28/2002
Reviewed By: Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.

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