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Common causes of parkinsonism
What are the most common causes of parkinsonism?
In a highly selected population, such as that attending a movement disorders clinic, Parkinsons disease is responsible for 77.7% of the cases of parkinsonism.
The other most frequent causes are parkinsonism-plus syndrome (12.2%), secondary parkinsonism (8.2%), and inherited neredodegenerative parkinsonism (0.6%).
Most common causes of parkinsonism Causes of Parkinsonism
| I. Idiopathic Parkinsonism |
| Parkinson’s disease |
| Sporadic form |
| Familial form |
| II. Secondary Parkinsonism |
| Drug induced |
| Dopamine receptor blockers (neuroleptics, antiemetics such as metoclopramide) |
| Dopamine depleters (reserpine, tetrabenazine) |
| Calcium channel blockers (flunarizine, cinnarizine, diltiazem) |
| Lithium |
| Methyldopa |
| Hemiparkinsonism–hemiatrophy syndrome |
| Hydrocephalus |
| Normal pressure hydrocephalus |
| Noncommunicating hydrocephalus |
| Hypoxia |
| Infectious diseases |
| Postencephalitic parkinsonism |
| Acquired immunodeficiency syndrome |
| Intracytoplasmic hyaline inclusion disease |
| Creutzfeldt–Jakob disease |
| Subacute sclerosing panencephalitis |
| Metabolic |
| Acquired hepatocerebral degeneration (chronic liver insufficiency) |
| Hypocalcemic parkinsonism |
| Paraneoplastic parkinsonism |
| Syringomesencephalia |
| Toxin |
| Carbon disulfide |
| Ethanol |
| Carbon monoxide |
| Manganese |
| Cyanide |
| Methanol |
| Disulfiram |
| MPTP |
| Trauma |
| Tumor |
| Vascular |
| Multi-infarcts |
| Binswanger’s disease |
| Lower body parkinsonism |
| III. Parkinsonism-Plus Syndromes |
| Diffuse Lewy body disease |
| Progressive supranuclear palsy |
| Corticobasal degeneration |
| MSA |
| MSA with predominant parkinsonism (MSA-P) |
| MSA with predominant cerebellar ataxia (MSA-C) |
| Alzheimer’s disease–parkinsonism |
| Parkinsonism–dementia–amyotrophic lateral sclerosis |
| Progressive pallidal atrophy |
| IV. Heredodegenerative Diseases |
| Ceroid lipofuscinosis |
| X-linked dystonia–parkinsonism |
| Gerstmann–Strausler–Scheinker disease |
| Disinhibition–dementia–parkinsonism |
| Familial OPCA amyotrophy complex |
| Neurodegeneration with brain iron accumulation |
| Autosomal dominant Lewy body disease |
| Huntington’s disease |
| Hereditary ceruloplasmin deficiency |
| Dopa-responsive dystonia |
| Familial progressive subcortical gliosis |
| Familial basal ganglia calcification |
| Machado–Joseph disease |
| Familial parkinsonism with peripheral neuropathy |
| Mitochondrial cytopathies with striatal necrosis |
| Parkinsonian–pyramidal syndrome |
| Neuroacanthocytosis |
| Wilson’s disease |
MPTP , 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine; OPCA , olivopontocerebellar atrophy; MSA , multiple system atrophy.
Sources
Azher SN, Jankovic J: Clinical aspects of progressive supranuclear palsy. Handb Clin Neurol 89:461-473, 2008.
