Brain & Nervous System Parkinson's Disease What Are Parkinson's Plus Syndromes? By Sarah Jividen, RN Sarah Jividen, RN LinkedIn Sarah Jividen, RN, BSN, is a freelance healthcare journalist and content marketing writer at Health Writing Solutions, LLC. She has over a decade of direct patient care experience working as a registered nurse specializing in neurotrauma, stroke, and the emergency room. Learn about our editorial process Published on September 21, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Diana Apetauerova, MD Medically reviewed by Diana Apetauerova, MD LinkedIn Diana Apetauerova, MD, is board-certified in neurology with a subspecialty in movement disorders. She is an associate clinical professor of neurology at Tufts University. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Progressive Supranuclear Palsy Cortical-Basal Ganglionic Degeneration Multiple System Atrophy Lewy Body Dementia Parkinson's disease is the most common degenerative neurological disorder of the central nervous system. It mainly affects movement and motor skills. Other neurological diseases mimic many Parkinson's disease symptoms. These disorders are referred to as Parkinson plus syndromes, or atypical parkinsonian syndromes. They are related to Parkinson's disease because they all negatively affect the brain or spinal cord nerve cells, and they are progressive with no available cure. This article provides an overview of the most common Parkinson's plus syndromes. Getty Images Progressive Supranuclear Palsy Progressive supranuclear palsy (PSP) is an uncommon brain disorder. This disease is caused by nerve cell damage in the brain that leads to walking, balance, and eye movement problems. Over time, PSP worsens and leads to an inability to think and control movement properly. PSP is caused by a buildup of a protein (Tau) in the brain's nerve cells. This protein is believed to degenerate and destroy other essential proteins within the brain's nerve cells. While it's normal to have low levels of Tau in the brain, people with PSP do not break down Tau correctly, and it increases to high levels. PSP signs and symptoms can mimic those of Parkinson's disease and may include: Balance issues and fallsEye problems and vision changesTrouble with speech and swallowingMemory issuesEmotional outburstsDepression Because these symptoms are similar to Parkinson's disease, it can take time to diagnose it properly. Symptoms unique to PSP that do not usually occur in Parkinson's can include: Being unable to move your eyes properly or downwardFalling backwardLack of severe shaking or tremors PSP Treatment Unfortunately, there is no cure or effective treatment for PSP, though some patients will be treated with Parkinson's medications to help with balance issues. Patients may also use things like specialized glasses, walkers, and regular physical therapy to help improve their quality of life. Cortical-Basal Ganglionic Degeneration Cortical-basal ganglionic degeneration (CBGD) is a rare neurological disease in which nerve cells in the brain break down and die over time. Similar to Parkinson's disease, the most commonly impacted areas control body movement and thinking. CBGD is progressive, which means it worsens slowly over time, and it usually occurs in people over the age of 60. The exact cause of CBGD is unknown. However, researchers believe there may be an environmental or genetic factor. Difficulty moving a limb or one side of the body is usually the first sign of CBGD, but over time it may affect every limb. Signs and symptoms of CBGD may include: Slight tremorSlow movementMuscle spasmsSpeech or language problemsDifficulty swallowingPoor coordinationInability to perform purposeful movementsUncontrolled eye movement There is no cure for CBDG, and there are currently no treatment methods to slow its progression. However, there are medications and other alternative treatments that can manage symptoms. Some of the same medications used to treat Parkinson's disease are also used to treat CBDG. Physical, occupational, and speech therapy may also be useful to help mitigate symptoms. Multiple System Atrophy Multiple system atrophy (MSA) is an uncommon neurological disease caused by the death of nerve cells in the brain and spinal cord. This is also a progressive disorder, meaning it becomes worse over time. MSA affects the involuntary (autonomic) nervous system and body movement. Some of the involuntary body functions the autonomic nervous system is responsible for include: Blood pressureBreathingBody temperatureSleepDigestionUrinationMotor movementSexual function The exact cause of MSA is unknown. However, it is known that a type of protein (alpha-synuclein) is found in larger amounts in the nerve-supporting cells of the brains of MSA patients. This protein is responsible for making the outer portion of nerve cells, called the myelin sheath. The myelin sheath allows for the electrical transmission of information between the brain and body. The same protein also builds up in patients who have Parkinson's disease, but on the inside of nerve cells. There are two types of MSA: The parkinsonian type: Symptoms mimic those of Parkinson's disease, primarily including stiffness, tremor, and slow movement.The cerebellar type: Symptoms involve balance and coordination problems. Early signs and symptoms of MSA may include: Slow movement Tremors Rigidity Lack of coordination Impaired speech Bladder control problems Orthostatic hypotension (when blood pressure drops due to standing up) There is no cure for MSA, and there are currently no treatments designed to specifically treat it. Treatment is usually aimed at helping to provide symptom relief. Disease Progression MSA usually progresses more quickly than Parkinson's disease. Patients often require a walking aid within a few years of symptom onset. Lewy Body Dementia Lewy body dementia (LBD) is a type of dementia that progresses over time. LBD occurs when protein deposits called Lewy bodies occur in the brain's nerves cells. The affected nerve cells are responsible for memory, thinking, and motor movement. Lewy bodies are also found in patients with other neurological diseases such as Parkinson's disease and Alzheimer's disease. This has led some researchers to believe there is a connection between the accumulation of proteins that cause buildup and plaque found in the brain with diagnostic imaging. LBD is a less common type of dementia than Alzheimer's disease. However, it is progressive and results in a decline in mental abilities. Symptoms of LBD are similar to those of Parkinson's and Alzheimer's and can include: Rigid musclesSlow movementBalance and coordination issuesTremorsPoor postureDifficultly swallowingChanges in alertness or attentionVisual hallucinationsMemory lossSleep problemsChanges in mood and behavior There is no cure for LBD. However, some medications can help with symptom management, including sleep medications, antidepressants or antipsychotics, and medications approved to treat Alzheimer's. Physical, occupational, and speech therapy are also beneficial for LBD patients. Lewy Body Dementia and Alzheimer's The memory loss in Lewy body dementia is less severe than it is with Alzheimer's. However, delusions and hallucinations are more common in the early stages of LBD. Sleep disturbances are also more likely in LBD. A Word From Verywell Distinguishing between Parkinson's disease and the various Parkinson's plus syndromes can be challenging and make for a difficult diagnosis. Be very clear and descriptive with your healthcare provider about the symptoms you are experiencing to ensure an accurate diagnosis. While there are no cures for these Parkinson's plus syndromes, there are medications and therapies that can help mitigate symptoms. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Olfati N, Shoeibi A, Litvan I. Progress in the treatment of Parkinson-Plus syndromes. Parkinsonism & Related Disorders. 2019;59:101-110. doi:10.1016/j.parkreldis.2018.10.006 National Institute of Neurological Disorders and Stroke. Progressive supranuclear palsy fact sheet. National Organization for Rare Disorders. Progressive supranuclear palsy. Johns Hopkins Medicine. Progressive supranuclear palsy. National Organization for Rare Disorders. Corticobasal degeneration. Reich SG, Grill SE. Corticobasal degeneration. Curr Treat Options Neurol. 2009;11(3):179-185. doi:10.1007/s11940-009-0021-9 Multiple System Atrophy Coalition. What is multiple system atrophy? National Institute of Neurological Disorders and Stroke. Multiple system atrophy fact sheet. National Institute on Aging. What is lewy body dementia? Causes, symptoms, and treatments. Alzheimer's Association. Lewy body dementia. National Institute of Neurological Disorders and Stroke. Lewy body dementia: hope through research.