Secondary parkinsonism
Alternative names:
parkinsonism - secondary
Treatment:
The treatment is aimed at control of symptoms.
If the symptoms are mild, no treatment may be required.
If the condition is caused by a medication, the benefits of the medication may be weighed against the severity of symptoms. If appropriate, medications may be stopped or changed by the health care provider.
Treatment of underlying conditions (such as stroke, infections) may reduce symptoms.
Medications may be used if symptoms interfere with the ability to perform daily activities. The medication, and/or dose, timing, or combination may need to be adjusted as symptoms change. Many of the medications may cause severe side effects, so monitoring and follow up by the health care provider are important. As a rule, response in secondary parkinsonism is disproportionate to all medical therapy compared to Parkinson's disease.
Medications include: - amantadine and/or anticholinergic medications
- levodopa
- carbidopa
Additional medications may include antihistamines, antidepressants, bromocriptine, 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 the symptoms worse.
Physical therapy, speech therapy, and occupational therapy may help promote function and independence, and may help maintain skills, positive attitude, and minimize depression.
Simple aides 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).
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:
- disability, varying degrees
- difficulty swallowing/eating
- difficulty performing daily activities
- injuries from falls
- side effects of medications
- debilitation and associated conditions:
Calling your health care provider:
Call your health care provider if symptoms of secondary parkinsonism 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 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).
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