☆ Are Parkinson’s disease and Parkinson’s syndrome the same thing? Parkinson’s disease and Parkinson’s syndrome are not exactly the same thing. Broadly speaking, Parkinson’s syndrome includes Parkinson’s disease, Parkinson’s superimposed syndrome (also known as atypical Parkinson’s disease), secondary Parkinson’s syndrome, and genetically related disorders. Parkinson’s syndrome in the narrow sense refers only to the latter three. When applying the concept of Parkinson’s syndrome, it is generally referred to in the narrow sense. The following all use the narrow concept. ☆ What are the differences between the symptoms of Parkinson’s disease and Parkinson’s syndrome? Parkinson’s disease and Parkinson’s syndrome are not the same disease, but they share common symptoms, including bradykinesia, resting tremor and myotonicity. Parkinson’s syndrome, however, has a number of signs and symptoms that appear earlier than those listed above (signs need to be examined by a doctor, so patients with Parkinson’s disease should be seen in person). These signs and symptoms include: hallucinations, dementia, unstable walking and stepping on cotton (cerebellar ataxia), dizziness and even blackness when standing (upright hypotension), sexual dysfunction, urinary incontinence, falling backwards, restricted up and down gaze (difficulty in going down stairs because of restricted downward gaze), pathological reflexes, dysfunction, compound sensory disorder, dissident hand (feeling that the hand is not one’s own and does not follow one’s (feeling that the hand is not one’s own and does not follow one’s own command), etc. ☆ How to distinguish between the two diseases during the examination and diagnosis? Parkinson’s syndrome is not a single disease, but at least several dozen diseases. The common ones include multiple system atrophy, progressive supranuclear palsy, Lewy body dementia, and corticobasal ganglion degeneration, which belong to Parkinson’s superimposed syndrome. There are also vascular Parkinson’s syndrome caused by cerebrovascular disease, Parkinson’s syndrome caused by encephalitis, drugs or poisoning, trauma, etc., and other brain diseases such as normal cranial pressure hydrocephalus, which are secondary Parkinson’s syndrome. There are also genetically related Parkinson’s diseases. The physician’s first diagnosis should include a medical history to rule out various secondary factors, and a careful neurological examination to understand whether there are neurological signs beyond Parkinson’s disease. If there are no signs and symptoms as described above, Parkinson’s disease is a strong possibility. If there are good signs and symptoms as described in the question above, Parkinson’s syndrome should be considered first. In addition, olfactory examination (Parkinson’s disease mostly has decreased sense of smell), nigrostriatal ultrasound, and PET imaging of dopamine transporter protein (mainly to differentiate from primary tremor) and cardiac BIMG PET imaging (Parkinson’s disease mostly is impaired) can be done when conditions permit, which can help in diagnosis. ☆ Can both be treated with dopamine-based drugs? Parkinson’s syndrome, especially secondary ones, should be treated for the cause. Both can be treated with dopamines. L-dopa drugs are preferred. Monoamine oxidase inhibitors can also be used. Dopamine agonists are generally not preferred because they can aggravate cognitive impairment and hallucinations. ☆ Does Parkinson’s syndrome disappear with the treatment of the primary disease, such as tremor? For secondary Parkinson’s syndrome, if it is caused by drugs, the symptoms may disappear if the drugs are stopped in time. Surgery for normal cranial pressure hydrocephalus can significantly improve symptoms. Parkinson’s superposition syndrome is a degenerative disease and is unlikely to be cured.