Patient Care Services at University of Miami

Welcome to the Parkinsonism page at the University of Miami’s Division of Movement Disorders. Here, we explore the spectrum of disorders known as parkinsonism, which share some symptoms with Parkinson’s Disease (PD) but differ in various crucial aspects. Parkinsonisms, or atypical parkinsonian syndromes, include conditions like Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), and others. These disorders may mimic PD but are distinct in their causes, progression, response to treatment, and underlying pathology.

Unlike PD, which primarily involves the degeneration of dopamine-producing neurons in the substantia nigra, parkinsonisms can affect multiple areas of the brain, leading to a broader range of symptoms and generally a more rapid progression. Treatment strategies and patient care need to be highly tailored, considering the specific characteristics of each type of parkinsonism.

Our division is dedicated to providing comprehensive care and advanced treatment options for these complex disorders. We leverage our expertise in neurology, cutting-edge research, and a multidisciplinary approach to offer the best possible outcomes for our patients. Explore our resources and learn how our specialized clinics cater to the unique needs of those affected by various forms of parkinsonism, enhancing both understanding and management of these challenging conditions.

Multiple System Atrophy (MSA): Multiple System Atrophy is a progressive neurodegenerative disorder characterized by a combination of symptoms that affect both movement and autonomic functions. MSA is divided into two primary types based on the predominant symptoms at the onset: parkinsonian-type (MSA-P), which resembles Parkinson’s Disease but with poorer response to dopamine therapies, and cerebellar-type (MSA-C), which mainly presents with ataxia, or coordination problems. The disease progresses more rapidly than Parkinson's, and the involvement of multiple systems often leads to significant physical disability.

Progressive Supranuclear Palsy (PSP): Progressive Supranuclear Palsy is a rare brain disorder that causes serious problems with walking, balance, and eye movements. The disease results from the deterioration of cells in areas of your brain that control body movement and thinking. PSP often presents with symptoms that include vertical gaze palsy, where the ability to look up or down is severely compromised, and postural instability, which often leads to falls. This condition shares some symptoms with Parkinson’s Disease but is distinct in its cause and progression.

Corticobasal Degeneration (CBD): Corticobasal Degeneration is a rare condition that can cause gradually worsening problems with movement, speech, memory, and swallowing. Patients often present with what is known as cortical sensory loss, limb rigidity, and dystonia, making it distinct from Parkinson's Disease. The symptoms are typically asymmetric, affecting one side of the body more than the other. CBD is associated with significant neuronal loss and gliosis in the cerebral cortex and basal ganglia.

Vascular Parkinsonism: Vascular Parkinsonism is caused by multiple small strokes in the basal ganglia, the area of the brain that controls movement. Unlike typical Parkinson’s Disease, which is a degenerative condition, vascular parkinsonism is a result of blood vessel problems. Symptoms may resemble those of Parkinson's but often include a lower body focus, problems with gait and balance, and less tremor. The progression can be stepwise, with periods of stability interrupted by episodes of worsening symptoms.

Normal Pressure Hydrocephalus (NPH): Normal Pressure Hydrocephalus is characterized by the triad of symptoms: difficulty walking, impaired bladder control leading to urinary incontinence, and cognitive dysfunction. It is caused by an abnormal buildup of cerebrospinal fluid in the ventricles of the brain, which can sometimes be treated with surgical intervention. Unlike Parkinson’s Disease, NPH can potentially be reversible if diagnosed and treated early, particularly with the surgical insertion of a shunt to drain excess fluid.

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