It is best to think of the Parkinson’s Plus syndromes as the sisters of Parkinson’s disease.
Although many diseases are similar to Parkinson’s disease, the changes they produce and their symptoms are slightly different. It’s why we think of these diseases as the sisters of Parkinson’s disease.
Another name for them is the “Parkinson’s Plus” syndromes.
PSP, MSA, CBD, and other “Parkinson’s Plus” diseases are like the sisters of Parkinson’s disease.
There are three common Parkinson’s Plus syndromes.
Because it is sometimes impossible to tell PSP, MSA, and CBD apart, doctors sometimes diagnose the patient as having a “Parkinson’s Plus” syndrome without noting the specific disease.
As the years go by, the appearance of characteristic features (such as eye movement problems in PSP) may enable your doctor to make a more precise diagnosis.
Which Symptoms May Indicate a Parkinson’s Plus Syndrome?
If you have any of the following features, you may have a Parkinson’s Plus syndrome. These features are called “red flags”. This means that if you have one of these symptoms, your doctor is supposed to pause and think.
Red flag. Your doctor will be extra careful if you have any of the following symptoms.
'Red Flags' suggesting that you may have a Parkinson's Plus Syndrome
1. Lack of response to Levodopa. 2. Frequently falling down, especially backwards. 3. Severe talking or swallowing problems. 4. Problems with eye movement. 5. Impotence. 6. Blurring of vision. 7. Blacking out when rising from a seated position. 8. Problems with thinking or memory loss. 9. Personality changes. 10. Symptoms only in the legs while the arms and hands are completely normal. 11. Rapid progression of the disease
What is the Treatment for a Parkinson’s Plus Syndrome?
The treatment for a Parkinson’s Plus syndrome is the same as the treatment for Parkinson’s disease itself.
Many patients respond to Levodopa. However, what’s challenging is that sometimes Levodopa does not have a dramatic effect. It may also happen that this effect may not last for many years. Therefore, the response to levodopa is somewhat unpredictable.
Once it enters the brain, Levdoopa is converted into Dopamine.
That being said, a significant proportion of patients with Parkinson’s Plus syndromes respond positively to a comprehensive treatment effort. This effort should include the treatment of special problems associated with each syndrome. Therefore, it is crucial to figure out which kind of Parkinson’s Plus syndrome early you have so that these specific problems can be treated.
For example:
In PSP, the patient frequently falls backwards because the areas of the brain responsible for balance are not functioning well. In this case, balance training can help.
In MSA, the patient can fall because of a drop in blood pressure when they get up. In this case, they should drink enough water and try to get up slowly to prevent falls. Some medications can also prevent falls.
What is Progressive Supranuclear Palsy (PSP)?
PSP is the most common of the “Parkinson’s Plus” syndromes. Patients with PSP frequently fall backwards.
MSA is the second most common of the “Parkinson’s Plus” syndromes. Patients with MSA have trouble with a part of their nervous system that controls blood pressure, heart rate, sweating and sexual function.
What are Other Types of Parkinson’s Plus Syndromes?
There are many other Parkinson’s Plus Syndromes. Since it’s not possible to describe each of these in detail here, I will mention their names and certain key characteristics.
Corticobasal Degeneration: Characterized by difficulty using automatic movements of an arm or hand.
Dementia with Lewy Bodies: Characterized by hallucinations & disorganized behaviour.
Frontotemporal dementia (“Pick’s disease”): Characterized by personality changes, including impulsivity and dis-inhibition.
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar
Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.
Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.
He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.
Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted… More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond… More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and… More cons.
I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains… More the issue in much greater details. He has really been of great help. My father is much better now.
One of the best doctors in Mumbai,listen to patients with concern very helpful, takes advise of other doctors very seriously. Examines the disease very… More carefully and advises patient of the medicine accordingly . Over all a good human being.
Dr Kharkar gives you all the time you need to hear you out in complete detail. He probes in depth to ensure he has managed to gain all data points to find… More the best way forward medically for you. He is an authority on the subject. After 4 years of suffering I have found my go to doctor
We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications… More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for… More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed… More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you
We have visited the hospital and meet the Dr. S. Kharkar. And my personal experience is very much better and exilent. My father is very well recover as… More we thought. Thanks to Nanavati Hospital and Dr. S. Kharkar.
The services that I received from doctor Siddharth kharkar is excellent ,and the other doctor is also very good who had taken initial discussion with me… More ...and the staff are friendly and ensure that I am properly informed about my health and care and would highly recommend to anyone..
Had very Severe migraine attacks for years and suddenly my migraine had triggered for continuous 5 days thats when I contact Dr Siddharth and was fortunate… More to have a effective medication which help me reduced my triggers and headaches..Lucky in few months I have very less days of headache in a month and can do my Daily life with much ease.
My experience with Dr Siddharth Kharkar was really awesome. It’s always great to be in the presence of someone who is a renowned expert in his field &… More it brings peace of mind that the advice will obviously be the correct one. In addition, his ability to convey complex workings of the human brain in such simple terms that a layman like me could easily understand was something I really appreciated. I heartily Thank Dr Kharkar for his astute advice & gladly recommend him to anyone who needs a neurologist.
Best Dr. we have ever meet. Dr. Listened to us patiently and gave us the proper solution. No unnecessary test or didn’t frighten us. Thank you so much… More Dr.
Great doctor!! Really appreciate.The doctor diagnosed me correctly and start treatment that will help me a lots to improve my condition. The doctor is… More really good, calm and his nature is down to earth, gives confidence to patient!!! Thank you!!!
We had been looking for a specialist in parkinsons for a while now, for my father and when we found Dr. Siddharth Kharka's details on Google, we were… More partly relieved. Partly because, we were all very anxious not knowing how would our visit turn out. I appreciate Dr. Kharkar and his team. He was very clear in his explanations, his knowledge about parkinsons. He took the time to answer the questions we had, went over the diagnosis and started necessary treatment immediately. The only drawback we experienced was the waiting time. Overall, we left the clinic satisfied, knowing much more than when we walked in. We would highly recommend him to anyone looking for a specialist.
I have visited the doctor clinic for the first timeBut he gave good advice and helped me overcomeMy doubts and queries. It was a good experience.I am very… More thankful for cooperation.
Hi Sharing my experience with Dr KharkarI had consulted with dr regarding my husband’sProblems of tremors. Dr immediately diagnosed on video consultation… More and could help him to control the tremors s of Parkinson’s disease.I found him genuinely polite and free to talk n patiently listening to the patients problem.Now my husband regained his balance n tremors controlled. Many many thanks to Dr Kharkar
Consultation with the doctor was a very satisfying experience. Was empathetic in his approach, and responded positively to all the queries we had. Thank… More you doctor!
Dr Siddharth is one of the best Dr I have ever met. He is kind, polite, helpful and very selfless person. I have migraine and I am his patient since more… More than 2 years. The staff is always helpful and Dr Siddharth is just beyond words for me. Thank you for ur selfless service and kindness u give to all ur patients.
