Parkinson-plus syndromes are a group of neurological conditions that are similar to Parkinson's disease but have unique features. These syndromes can be hard to diagnose because the symptoms are like those of other conditions.

The most common types of Parkinson-plus syndromes are progressive supranuclear palsy (PSP), multiple system atrophy (MSA), cortical-basal ganglionic degeneration (CBGD), and dementia with Lewy bodies (DLB).

Progressive supranuclear palsy (PSP)

Progressive supranuclear palsy (PSP) is a rare disorder. Like Parkinson's disease, it causes problems with balance when a person walks or stands. Rigid and stiff muscles, especially in the neck and spine, make body movement hard. The symptom that most makes PSP different from Parkinson's disease is a problem with eye movement. This occurs along with the body movement problems.

Problems with speech and swallowing are more common and become worse in PSP than in Parkinson's disease. Problems with thinking and changes in the way a person acts and feels are also more common. PSP progresses more quickly than Parkinson's. It often leads to disability within 5 years.

While there is currently no cure for PSP, some symptoms may be controlled with medicines. Working with physical and speech therapists and a dietitian can also be helpful.

Multiple system atrophy (MSA)

Multiple system atrophy (MSA) is one disease with two main types. In one type, called MSA-Parkinsonian (MSA-P), Parkinson-like symptoms are the main problem. In the other type, called MSA-Cerebellar (MSA-C), balance and coordination problems are the main problem. MSA is a term also used for a group of rare disorders that reduce the function of the nervous system over time.

MSA-P symptoms may also include:

• Slow movement.
• Stiff muscles.
• Tremors.
• Urinary problems.
• Digestion problems.
• Jerky shaking of the hands when held up or outstretched.

MSA-C symptoms may also include:

• Changes in posture.
• Trouble swallowing.
• Speaking problems or a quivering voice.
• Abnormal eye movements.
• Erectile dysfunction.

Both MSA and Parkinson's disease can cause dizziness when standing up, due to a drop in blood pressure. This can lead to falls.

MSA can also cause noisy breathing, especially during sleep. This can be serious and should be discussed with your doctor.

There is no way to stop the nerve loss that occurs with MSA. But medicines can help relieve symptoms.

Cortical-basal ganglionic degeneration (CBGD)

Corticobasal syndrome (CBS) is a rare disorder that, over time, causes many areas of the brain to shrink. The first symptoms are usually clumsiness or stiffness in one arm or leg. Some people may also have early problems with thinking. But CBS also can cause changes in the way a person acts, speaks, or moves. Movement symptoms often start in one arm or leg. Some symptoms of CBS are similar to Parkinson's disease, but they may come later as CBS progresses. These may include:

• Tremor.
• Stiffness.
• Problems with balance.
• Slow movement.
• Muscle tightness that pulls the hand or arm into odd positions.
• Jerking movements.
• Trouble doing tasks with the hands, like buttoning a shirt.

Problems with understanding spoken or written language may develop. A problem called "alien limb" can occur, in which the person:

• Has trouble controlling the movement of a limb (usually the arm).
• May feel that an arm or leg is not their own.
• Has a limb that acts with a "mind of its own."

Although there is no cure for CBS, medicines can treat symptoms. Physical, occupational, and speech therapy may also be use to manage the condition.

Dementia with Lewy bodies (DLB)

Dementia with Lewy bodies (DLB) is a brain disease that over time causes a loss of mental skills and other problems with the nervous system. It is linked to protein deposits called Lewy bodies in brain cells.

The dementia symptoms can include problems with attention, time management, problem solving, learning, and memory.

Someone with this condition will also have other symptoms. These may include sudden confusion; seeing things that aren't there; sleep problems; and trouble walking, tremors, or slow or stiff movement. Most symptoms get worse over time.

Although there is no cure for DLB, treatment can reduce symptoms of the disease.