G21.9

Clinical Causes: Use of certain medications, especially antipsychotics and anti-nausea drugs Exposure to neurotoxins or environmental toxins Brain injuries or strokes affecting motor control areas Infections that impact the nervous system Metabolic disorders such as Wilson’s disease

Key Symptoms: Bradykinesia, or slowness of movement Muscle rigidity or stiffness Resting tremor, often starting in one limb Postural instability and balance problems Shuffling gait and difficulty with coordination Reduced facial expression, sometimes called 'masked face' Speech difficulties, such as softer or slurred speech Difficulty swallowing in some cases

Diagnosis Path: Diagnosing secondary Parkinsonism involves a comprehensive review of medical history, including medication use and exposure to toxins. A physical and neurological examination assesses movement and muscle tone. Additional tests, such as brain imaging (MRI or CT scans), may be performed to rule out other neurological conditions and identify potential causes. Blood tests can also help evaluate metabolic or infectious causes. Recognizing the cause is essential for guiding treatment and management.

Treatment Protocols: Treatment strategies focus on addressing the underlying cause and managing symptoms. Discontinuing or adjusting causative medications may lead to symptom improvement. In some cases, medications used for Parkinson's disease, like levodopa or dopamine agonists, can be beneficial, although their effectiveness varies. Physical and occupational therapy can help improve mobility and daily function. Managing associated issues, such as depression or cognitive changes, is also important. The overall approach aims to enhance quality of life and mobility.