Understanding the Different Types of Parkinsonism: Symptoms, Management & Top Tips

Parkinson’s disease is a progressive neurological condition that affects movement and other functions of the body. However, not all people with Parkinson’s symptoms have Parkinson’s disease – some may have a group of related conditions known collectively as Parkinsonism.

In this blog, we’ll explore:

• The different types of Parkinsonism

• Key symptoms and how they differ

• Medical and physiotherapy management

• The role of other healthcare professionals

• Practical tips for living well with Parkinson’s

🌿 What Is Parkinsonism?

Parkinsonism is an umbrella term used to describe a group of neurological conditions that cause movement symptoms similar to Parkinson’s disease, such as:

• Tremor

• Stiffness (rigidity)

• Slowness of movement (bradykinesia)

• Balance and walking difficulties

The most common type is Idiopathic Parkinson’s Disease (PD). Other forms include:

• Progressive Supranuclear Palsy (PSP)

• Multiple System Atrophy (MSA)

• Corticobasal Syndrome (CBS)

• Vascular Parkinsonism

• Drug-induced Parkinsonism

🧠 Idiopathic Parkinson’s Disease (PD)

This is the most recognised and common form of Parkinsonism.

Key Symptoms:

• Resting tremor

• Rigidity

• Bradykinesia

• Postural instability

• "Freezing" of gait

• Micrographia (small handwriting)

• Masked facial expressions

Non-motor Symptoms:

• Constipation

• Sleep disturbances

• Mood changes (anxiety, depression)

• Memory problems

• Loss of smell

Medical Management:

• Levodopa (with carbidopa/benserazide): the most effective medication for motor symptoms

• Dopamine agonists, MAO-B inhibitors, COMT inhibitors for symptom control

• Medication timing is critical – especially in relation to meals (protein can interfere with absorption)

• Regular bowel movements are essential to aid medication absorption in the gut

Physiotherapy Focus:

• Gait re-education and cueing strategies

• Balance training

• Strength and flexibility exercises

• Posture and movement strategies

• Fall prevention

🧩 Progressive Supranuclear Palsy (PSP)

A rare form of Parkinsonism that progresses more rapidly than PD.

Distinct Symptoms:

• Difficulty with eye movements, especially looking up/down (supranuclear gaze palsy)

• Early postural instability and frequent falls

• Speech and swallowing problems

• Stiffness in the neck and trunk

• Less tremor than seen in PD

Medical Management:

• Limited response to Parkinson’s medication

• Management focuses on symptom control

• Speech and swallowing assessments essential

Physiotherapy Focus:

• Fall prevention strategies

• Visual cueing to compensate for eye movement issues

• Core strength and trunk control

• Education around safe transfers and mobility aids

🔁 Multiple System Atrophy (MSA)

A progressive neurodegenerative disorder affecting multiple systems in the body.

Key Symptoms:

• Parkinsonism symptoms (similar to PD)

• Autonomic dysfunction (e.g. low blood pressure, bladder issues)

• Cerebellar signs (e.g. ataxia, poor coordination)

• Speech and swallowing difficulties

Medical Management:

• Poor response to Levodopa

• Medications to support blood pressure and bladder function

• Multidisciplinary symptom management

Physiotherapy Focus:

• Managing coordination and balance

• Gait training and fall prevention

• Bladder and bowel management advice

🧠 Corticobasal Syndrome (CBS)

A rare, atypical Parkinsonian disorder with asymmetrical symptoms.

Key Symptoms:

• Stiffness and awkwardness in one limb

• Dystonia (involuntary muscle contractions)

• Apraxia (difficulty performing learned movements)

• Speech and cognitive impairments

Medical Management:

• Poor response to PD medication

• Focus is on multidisciplinary symptom management

Physiotherapy Focus:

• Movement re-education

• Task practice to maintain function

• Communication with occupational therapists for functional adaptations

🧬 Other Forms of Parkinsonism

Vascular Parkinsonism:

Caused by multiple small strokes affecting the brain’s movement centres.

Symptoms:

• More common in the lower limbs

• Difficulty with walking and balance

• Often without tremor

Management:

• Controlling risk factors (blood pressure, cholesterol)

• Medication may not be effective

Drug-Induced Parkinsonism:

Caused by medications that block dopamine, such as antipsychotics.

Reversible if medication is stopped early.

🤝 The Multidisciplinary Team

Effective Parkinson’s management involves a team approach, including:

• Neurologist: Specialist in diagnosis and medical management

• Parkinson’s Nurse Specialist: Key contact for ongoing care, medication support, and education

• Physiotherapist: Movement, mobility, and exercise specialist

• Occupational Therapist: Daily activity support and home adaptations

• Speech and Language Therapist: Swallowing and communication

• Dietitian: Nutrition advice, including bowel health

• Pharmacist: Ensures medication safety and timing

💊 Medication Tips & Bowel Management

• Take Parkinson’s medication on time – being late can cause a significant drop in mobility or "off" periods

• Avoid taking Levodopa with high-protein meals

• Stay hydrated and eat a high-fibre diet to avoid constipation

Constipation can impair the absorption of medication, reducing its effectiveness.

✅ Practical Hints & Tips

• Keep active daily – exercise is one of the best ways to manage symptoms and slow progression

• Routine helps – regular wake/sleep and medication times can reduce fluctuations

• Use visual or auditory cues (e.g. lines on the floor, rhythmic clapping) for movement or freezing

• Stay socially engaged – isolation can affect mood and cognition

• Join local or online Parkinson’s support groups

• Use aids and home adaptations early to maintain safety and independence

🌟 Final Thoughts

Living with Parkinson’s or an atypical Parkinsonism can be challenging, but with the right support, proactive management, and a strong team around you, many people continue to live active and fulfilling lives.

If you or a loved one are affected by Parkinsonism, don't hesitate to reach out to your local Parkinson’s nurse, GP, or physiotherapist. Early support makes all the difference.

If you'd like help navigating services, understanding your condition further, or accessing physiotherapy support at home, feel free to get in touch with your local healthcare team or Parkinson’s UK for trusted advice.