Parkinsonism is a neurological syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

 characterized by tremor
A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the...

, hypokinesia
Hypokinesia refers to decreased bodily movement. It is associated with basal ganglia diseases , mental health disorders and prolonged inactivity due to illness, amongst other diseases.Hypokinesia describes a spectrum of disorders:...

, rigidity, and postural instability
Balance disorder
A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by feelings of giddiness or wooziness, or having a sensation of movement, spinning, or floating...

. The underlying causes of parkinsonism are numerous, and diagnosis can be complex. While the neurodegenerative condition Parkinson's disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...

 (PD) is the most common cause of parkinsonism, a wide-range of other etiologies
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....

 can lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of non-PD neurological conditions.
Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazine
Phenothiazine is an organic compound that occurs in various antipsychotic and antihistaminic drugs. It has the formula S2NH. This yellow tricyclic compound is soluble in acetic acid, benzene, and ether. The compound is related to the thiazine-class of heterocyclic compounds...

s (such as perphenazine and chlorpromazine
Chlorpromazine is a typical antipsychotic...

), thioxanthene
Thioxanthene is a chemical compound in which the oxygen atom in xanthene is replaced with a sulfur atom. It is also related to phenothiazine. Several of its derivatives are used as typical antipsychotics in the treatment of schizophrenia and other psychoses....

s (such as flupenthixol and zuclopenthixol) and butyrophenone
Butyrophenone is a chemical compound ; some of its derivatives are used to treat various psychiatric disorders such as schizophrenia, as well as acting as antiemetics....

s (such as haloperidol (Haldol)), piperazine
Piperazine is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Piperazine exists as small alkaline deliquescent crystals with a saline taste....

s (such as ziprasidone), and, rarely, antidepressants.


If PD has been excluded, the differential diagnosis
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

 or list of potential causes for this syndrome includes:
  • AIDS
    Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

     can sometimes lead to the symptoms of Parkinson's disease
    Parkinson's disease
    Parkinson's disease is a degenerative disorder of the central nervous system...

    , due to commonly causing dopaminergic dysfunction
  • Corticobasal degeneration
    Corticobasal degeneration
    Corticobasal degeneration or Corticobasal Ganglionic Degeneration is a rare progressive neurodegenerative disease involving the cerebral cortex and the basal ganglia. It is characterized by marked disorders in movement and cognitive dysfunction...

  • Creutzfeldt-Jakob disease
    Creutzfeldt-Jakob disease
    Creutzfeldt–Jakob disease or CJD is a degenerative neurological disorder that is incurable and invariably fatal. CJD is at times called a human form of mad cow disease, given that bovine spongiform encephalopathy is believed to be the cause of variant Creutzfeldt–Jakob disease in humans.CJD...

  • Dementia pugilistica
    Dementia pugilistica
    Dementia pugilistica is a type of neurodegenerative disease or dementia, which may affect amateur or professional boxers as well as athletes in other sports who suffer concussions...

     or "boxer's dementia" is a condition that occurs in boxers due to chronic brain trauma
  • Diffuse Lewy body disease
  • Drug-induced parkinsonism (due to drugs such as antipsychotics, metoclopramide
    Metoclopramide is an antiemetic and gastroprokinetic agent. It is commonly used to treat nausea and vomiting, to facilitate gastric emptying in people with gastroparesis, and as a treatment for the gastric stasis often associated with migraine headaches.-Medical uses:Metoclopramide is commonly...

    , MPTP
    MPTP is a neurotoxin precursor to MPP+, which causes permanent symptoms of Parkinson's disease by destroying dopaminergic neurons in the substantia nigra of the brain...

  • Encephalitis lethargica
    Encephalitis lethargica
    Encephalitis lethargica or von Economo disease is an atypical form of encephalitis. Also known as "sleepy sickness" , it was first described by the neurologist Constantin von Economo in 1917. The disease attacks the brain, leaving some victims in a statue-like condition, speechless and motionless...

  • Multiple system atrophy
    Multiple system atrophy
    Multiple system atrophy is a degenerative neurological disorder. MSA is associated with the degeneration of nerve cells in specific areas of the brain. This cell degeneration causes problems with movement, balance and other autonomic functions of the body such as bladder control or blood pressure...

  • Pantothenate kinase-associated neurodegeneration
    Pantothenate kinase-associated neurodegeneration
    Pantothenate kinase-associated neurodegeneration , also known as neurodegeneration with brain iron accumulation 1 and formerly called Hallervorden-Spatz syndrome Pantothenate kinase-associated neurodegeneration (PKAN), also known as neurodegeneration with brain iron accumulation 1 (NBIA1) and...

     (Hallervorden-Spatz syndrome)
  • Progressive supranuclear palsy
    Progressive supranuclear palsy
    Progressive supranuclear palsy is a degenerative disease involving the gradual deterioration and death of specific areas of the brain....

  • Toxicity due to substances such as carbon monoxide
    Carbon monoxide
    Carbon monoxide , also called carbonous oxide, is a colorless, odorless, and tasteless gas that is slightly lighter than air. It is highly toxic to humans and animals in higher quantities, although it is also produced in normal animal metabolism in low quantities, and is thought to have some normal...

    , carbon disulfide
    Carbon disulfide
    Carbon disulfide is a colorless volatile liquid with the formula CS2. The compound is used frequently as a building block in organic chemistry as well as an industrial and chemical non-polar solvent...

    , manganese
    Manganism or manganese poisoning is a toxic condition resulting from chronic exposure to manganese and first identified in 1837 by James Couper.- Presentation :...

    , paraquat
    Paraquat is the trade name for N,N′-dimethyl-4,4′-bipyridinium dichloride, one of the most widely used herbicides in the world. Paraquat, a viologen, is quick-acting and non-selective, killing green plant tissue on contact. It is also toxic to human beings and animals...

    , mercury
    Mercury (element)
    Mercury is a chemical element with the symbol Hg and atomic number 80. It is also known as quicksilver or hydrargyrum...

    , hexane
    Hexane is a hydrocarbon with the chemical formula C6H14; that is, an alkane with six carbon atoms.The term may refer to any of four other structural isomers with that formula, or to a mixture of them. In the IUPAC nomenclature, however, hexane is the unbranched isomer ; the other four structures...

    , rotenone
    Rotenone is an odorless chemical that is used as a broad-spectrum insecticide, piscicide, and pesticide. It occurs naturally in the roots and stems of several plants such as the jicama vine plant...

    , and toluene
    Toluene, formerly known as toluol, is a clear, water-insoluble liquid with the typical smell of paint thinners. It is a mono-substituted benzene derivative, i.e., one in which a single hydrogen atom from the benzene molecule has been replaced by a univalent group, in this case CH3.It is an aromatic...

  • Vascular parkinsonism
  • Wilson's disease
    Wilson's disease
    Wilson's disease or hepatolenticular degeneration is an autosomal recessive genetic disorder in which copper accumulates in tissues; this manifests as neurological or psychiatric symptoms and liver disease...

     is a genetic disorder in which there is an abnormal accumulation of copper. The excess copper can lead to the formation of a copper-dopamine
    Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...

     complex, which leads to the oxidation of dopamine to aminochrome. The most common manifestations include: bradykinesia, cogwheel rigidity and a lack of balance.
  • Paraneoplastic syndrome
    Paraneoplastic syndrome
    A paraneoplastic syndrome is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. These phenomena are mediated by humoral factors excreted by tumor cells or by an immune response against the tumor...

    . Neurological symptoms caused by antibodies associated with various cancers
  • Neurodegeneration with brain iron accumulation (NBIA), A.K.A. Hallervorden-Spatz disease
  • Genetic
    • Rapid onset dystonia parkinsonism (DYT12)
    • Parkin mutation
    • X-linked dystonia parkinsonism (DYT3)
    • Autosomal recessive juvenile parkinsonism (ARJP)

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