Parkinson plus syndrome

Parkinson-plus syndromes are a group of diseases featuring the classical features of Parkinson's disease (tremor; rigidity; akinesia/bradykinesia; postural instability) with additional features that distinguish them from simple idiopathic Parkinson's disease.

The Parkinson-plus syndromes and their additional features are:

*Multiple system atrophy (MSA)
**cerebellar ataxia
**pyramidal weakness
**autonomic failure (previously known as Shy-Drager syndrome)
**nocturnal stridor
*Progressive supranuclear palsy (PSP)
**supranuclear palsy of eye movements (failure of voluntary vertical eye movements, especially downward gazing)
**pseudo-bulbar palsy
**dementia
*Corticobasal degeneration (CBD)
**cognitive impairment, often including some form of aphasia and/or apraxia, and eventually developing to a full dementia
**myoclonus
*Dementia with Lewy bodies (DLB)
**early cognitive impairment
**hallucinations
*Olivopontocerebellar atrophy (OPCA)
**ataxia
**dysarthria

It is said by neurologists that patients presenting with falls early in the course of a Parkinsonian illness are more likely to have a Parkinson-plus syndrome than idiopathic Parkinson's disease.

The Parkinson-plus syndromes are usually more rapidly progressive and less likely to respond to anti-parkinsonian medication than Parkinson's disease. However, the additional features of the diseases may respond to medications not used in Parkinson's disease.