What is Atypical Parkinson's? Is it the same as PD?

You might hear the term “atypical Parkinson’s” or “Parkinson-plus syndrome” used to describe a group of movement disorders that share some features with Parkinson’s disease. They tend to progress differently, and they don’t usually respond to standard dopamine replacement medications the way typical Parkinson’s does.

This group includes dementia with Lewy bodies (DLB), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD).

Why does the specific diagnosis matter?

Getting an accurate diagnosis helps shape the right care plan. Each condition and (each person) has its own symptom pattern and treatment needs, so knowing exactly what you’re dealing with makes it easier to find an approach that works.

The right treatment really does depend on the right diagnosis, since medications that help with one condition may not help with another. For example, standard dopamine therapy can sometimes bring on more noticeable visual hallucinations in people with DLB.

It’s also useful to have a general sense of how a condition tends to change over time. Good information and resources help people and their loved ones stay informed, feel more confident, and make clearer decisions about care together with their medical team.

How are these conditions diagnosed?

There isn’t one single test that identifies typical or atypical Parkinson’s. Instead, doctors build a picture using a combination of different assessments.

A neurologist will carry out a thorough clinical exam to assess physical symptoms. For both typical and atypical PD syndromes, they’ll look for things like slower movement, stiffness, tremor, balance changes, and freezing while walking. They’ll also look for other symptoms that can help distinguish one condition from another.

Other tests that may be part of the process:

• Eye tests

• Thinking tests (cognitive assessments)

• Brain MRI or PET scans

• A trial of dopamine replacement, to see how well someone responds

References

Keir G, Roytman M, Mashriqi F, Shahsavarani S, Franceschi AM. Atypical Parkinsonian Syndromes: Structural, Functional, and Molecular Imaging Features. AJNR Am J Neuroradiol. 2024 Dec 9;45(12):1865-1877. doi: 10.3174/ajnr.A8313. PMID: 39209485; PMCID: PMC11630880.

Höglinger, G.U., Kassubek, J., Csoti, I. et al. Differentiation of atypical Parkinson syndromes. J Neural Transm124, 997–1004 (2017). https://doi.org/10.1007/s00702-017-1700-4