Parkinson's Disease

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Postencephalitic Parkinsonism
As anyone will recall who has read the book, Awakenings, by neurologist Dr. Oliver Sacks, or seen the movie made from it, a severe viral disease called encephalitis lethargica struck down almost 5 million people worldwide in the years just after World War I. It disappeared during the 1920s, but not before it killed one-third of its victims and cast others into a seemingly catatonic state. This "sleeping sickness," as it was called in the United States, was postencephalitic parkinsonism, a disabling neurological disorder which often developed years after the acute phase of encephalitis lethargica had passed. Other viral infections, including western equine encephalomyelitis, eastern equine encephalomyelitis and Japanese B encephalitis, have been known to cause parkinsonian symptoms as well, though rarely.

Drug-Induced Parkinsonism
Sometimes the use of certain drugs can produce parkinsonian symptoms. These include chlorpromazine and haloperidol, drugs which are prescribed for psychiatric patients, metoclopramide, often used to treat stomach disorders, and reserpine, a blood pressure controlling drug. Changing the medication or adjusting its dosage usually moderates or eliminates the symptoms.

Striatonigral Degeneration
This condition is characterized by mild problems in the substantia nigra, but severe damage to other parts of the brain that usually are less affected by primary Parkinson's disease. Patients with striatonigral degeneration usually have greater muscular rigidity, and their disease progresses rapidly.

Arteriosclerotic Parkinsonism or Pseudoparkinsonism
A condition in which multiple small strokes cause damage to blood vessels in the brain, arteriosclerotic parkinsonism rarely causes tremors, but most people afflicted with it suffer dementia. The usual drugs used to treat parkinsonian symptoms are largely ineffective with pseudoparkinsonism.

Toxin-Induced Parkinsonism
Some toxins are known to cause parkinsonism. These include manganese dust, carbon disulfide, carbon monoxide and a chemical known as MPTP (1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine).

Parkinsonian symptoms also are known to appear in conjunction with other neurological disorders. Among these diseases are progressive supranuclear palsy, Huntington's disease, Alzheimer's disease, Creutzfeldt-Jakob disease and post-traumatic encephalopathy.

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