Blog

PARKINSON PLUS SYNDROME

Context

• A 65-year-old patient from France, suffering from Parkinson’s plus syndrome, a neurodegenerative disorder with limited surgical options, has undergone a high cervical spinal cord stimulation in a private hospital in Bengaluru.

Details

About Parkinson Plus Syndrome

• Parkinson Plus Syndrome (PPS), also known as atypical parkinsonism, refers to a group of neurodegenerative disorders characterized by symptoms similar to Parkinson's disease (PD) but with additional features and often faster progression.
• Distinct Features: PPS encompasses several conditions that share overlapping symptoms with PD but also exhibit additional motor and non-motor manifestations.

Types of Parkinson Plus Syndrome:

• Multiple System Atrophy (MSA): Characterized by a combination of parkinsonian symptoms, autonomic dysfunction, and cerebellar or pyramidal features.
• Progressive Supranuclear Palsy (PSP): Presents with vertical gaze palsy, early postural instability, falls, and cognitive impairment.
• Corticobasal Syndrome (CBS): Manifests with asymmetric parkinsonism, apraxia, alien limb phenomenon, and cortical sensory loss.
• Lewy Body Dementia (LBD): Involves cognitive impairment, visual hallucinations, fluctuating alertness, and parkinsonian symptoms.

Symptoms:

• Motor Symptoms:
  • Bradykinesia (slowness of movement)
  • Rigidity
  • Tremor (may be less prominent than in PD)
  • Postural instability
• Non-Motor Symptoms:
  • Autonomic dysfunction (e.g., orthostatic hypotension, urinary incontinence)
  • Cognitive impairment
  • Sleep disturbances (e.g., REM sleep behavior disorder)
  • Psychiatric symptoms (e.g., depression, anxiety)

Treatment:

• Medications: While some medications used for PD may provide symptomatic relief in PPS, response to treatment is often limited.
• Physical Therapy: Exercise programs and physical therapy can help improve mobility, balance, and muscle strength.
• Speech and Swallowing Therapy: Speech therapy can address speech and swallowing difficulties commonly seen in PPS.
• Supportive Care: Management of non-motor symptoms, including cognitive impairment and autonomic dysfunction, is essential for improving quality of life.