Common causes of parkinsonism

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.