Types of Parkinson's

All types of Parkinson’s disease are progressive, meaning symptoms will worsen over time as changes in the brain continue to evolve. However, each type of Parkinson’s can affect individuals differently depending on factors such as age of onset, genetics, co-existing conditions and response to treatment. With the right care, therapy and support network, it is absolutely possible to live well with Parkinson’s.

In this section, you’ll find information about the main types of Parkinson’s, how they differ, their symptoms and causes and what to expect over time.

Primary and Secondary Parkinsonism

Medical professionals often classify Parkinson’s-related conditions into primary and secondary parkinsonism.

Primary Parkinsonism

This includes idiopathic Parkinson’s disease, which is the most common and well-understood form. It is typically caused by the gradual loss of dopamine-producing nerve cells in a specific region of the brain. Most people diagnosed with Parkinson’s fall into this category.

Secondary Parkinsonism

This refers to parkinsonian symptoms caused by other conditions, injuries or medications. These can include drug-induced parkinsonism, vascular parkinsonism or parkinsonism related to other neurodegenerative diseases like multiple system atrophy (MSA) or progressive supranuclear palsy (PSP).

The progression of Parkinson’s is influenced by type, lifestyle, health factors and genetics, but support is available for all stages.

The Main Types of Parkinson’s and Related Disorders

1. Idiopathic Parkinson’s Disease

This is the most common and recognisable form of Parkinson’s. It typically begins with tremors, slowness of movement and stiffness, often starting on one side of the body. As it progresses, symptoms may include balance problems, speech changes, swallowing difficulties, fatigue and sometimes mild cognitive impairment.

Researchers believe this form is linked to the build-up of alpha-synuclein proteins (Lewy bodies) in brain cells, which disrupt normal cell function and lead to gradual cell death.

2. Parkinson’s Disease Dementia (PDD)

Some people with Parkinson’s develop dementia as the disease advances. Parkinson’s Disease Dementia typically occurs a year or more after the onset of motor symptoms. It is marked by memory loss, confusion, slowed thinking and difficulty concentrating.

PDD shares some pathological features with dementia with Lewy bodies, but its symptoms follow the development of movement issues, distinguishing it from other forms of dementia.

3. Dementia with Lewy Bodies (DLB)

Though separate from Parkinson’s, DLB is closely related and shares many symptoms. In DLB, cognitive symptoms (such as visual hallucinations, confusion and memory issues) appear before or alongside motor symptoms.

DLB is caused by widespread deposits of Lewy bodies—the same abnormal proteins seen in Parkinson’s disease—affecting both movement and cognition. It is often considered part of the same spectrum of disorders.

4. Vascular Parkinsonism

This type of parkinsonism is caused by reduced blood flow to the brain, typically due to small strokes. It often presents with lower body stiffness, difficulty walking and balance problems, rather than the classic tremor of idiopathic Parkinson’s.

Symptoms may appear suddenly or progress in a stepwise fashion, depending on stroke events.

5. Drug-Induced Parkinsonism

Certain medications, especially those that block dopamine receptors (like antipsychotics), can cause parkinsonian symptoms. Unlike idiopathic Parkinson’s, symptoms often improve once the medication is stopped, although recovery can take weeks or months.

6. Atypical Parkinsonian Syndromes

These rare disorders mimic Parkinson’s but progress more rapidly and respond poorly to traditional medications:

• Multiple System Atrophy (MSA): Affects movement, balance, blood pressure regulation and bladder control. May present with either Parkinson-like or cerebellar symptoms (problems with coordination and speech).
• Progressive Supranuclear Palsy (PSP): Notable for problems with balance, stiffness, eye movement difficulties and speech issues. PSP often leads to frequent falls early on.
• Corticobasal Degeneration (CBD): Causes asymmetrical movement problems, stiff limbs and difficulty with coordination. Language and cognitive skills may also decline.

These conditions are more complex and require specialised management.

Rarer types of Parkinsons

While idiopathic Parkinson’s disease is the most common form, it accounts for the majority of diagnoses. Rarer types of Parkinsonism make up only a small proportion of cases and often present at a younger age, sometimes before 60. These forms are typically more complex, progress faster, and may respond less effectively to standard Parkinson’s treatments.

Multiple System Atrophy (MSA)

Multiple System Atrophy is a rare and aggressive neurodegenerative disorder that shares some features with Parkinson’s but affects more areas of the brain. MSA causes a combination of Parkinsonian symptoms, problems with balance and coordination (ataxia), and autonomic dysfunction such as issues with blood pressure, bladder control, and digestion.

Symptoms of MSA:

• Muscle stiffness and slowness
• Impaired coordination and balance
• Difficulty swallowing and speaking
• Dizziness or fainting due to low blood pressure
• Bladder incontinence and erectile dysfunction

MSA progresses more rapidly than typical Parkinson’s and can be challenging to diagnose in its early stages.

Progressive Supranuclear Palsy (PSP)

PSP is a rare brain disorder that causes serious problems with walking, balance, eye movement, and speech. Unlike Parkinson’s, it doesn’t usually cause tremors, and falls tend to occur very early in the condition’s progression.

Symptoms of PSP:

• Trouble with eye movement, especially looking up or down
• Early postural instability and frequent falls
• Slurred speech and swallowing difficulties
• Changes in mood, behaviour and cognitive ability

People with PSP typically do not respond well to standard Parkinson’s medications like levodopa.

Corticobasal Degeneration (CBD)

Corticobasal Degeneration is a rare type of Parkinsonism that causes asymmetrical symptoms, usually affecting one side of the body more than the other. It can impact both movement and cognitive function.

Symptoms of CBD:

• Stiffness and jerky movements
• One-sided weakness and clumsiness
• Difficulty performing tasks despite knowing how (apraxia)
• Speech and language difficulties
• Behavioural changes and memory problems

CBD often overlaps with symptoms seen in frontotemporal dementia.

Vascular Parkinsonism

Caused by reduced blood flow to areas of the brain involved in movement, vascular parkinsonism tends to affect the lower body more significantly, leading to difficulty walking and balance issues. It may result from a series of small strokes and can sometimes be misdiagnosed as typical Parkinson’s.

Symptoms of Vascular Parkinsonism:

• Stiffness and weakness in the legs
• Slow, shuffling gait
• Poor balance and frequent falls
• Less prominent tremors than idiopathic Parkinson’s

Drug-Induced Parkinsonism

Certain medications, particularly antipsychotics or anti-nausea drugs, can cause temporary Parkinson-like symptoms by blocking dopamine receptors in the brain.

Symptoms of Drug-Induced Parkinsonism:

• Similar to idiopathic Parkinson’s: tremors, rigidity, slow movement
• Usually affect both sides of the body equally
• Often improve once the medication is stopped, though symptoms can persist for months

Parkinson’s-Related Conditions

Some neurodegenerative conditions overlap with Parkinson’s or share its features, including:

• Huntington’s disease
• Wilson’s disease
• Normal Pressure Hydrocephalus (NPH)
• Dementia with Lewy Bodies (DLB)

These conditions may cause Parkinsonian symptoms but have distinct causes and progressions. Accurate diagnosis is essential for appropriate treatment.

Young-Onset Parkinson’s Disease

Young-onset Parkinson’s disease (YOPD) refers to cases diagnosed before the age of 50. While the core symptoms are the same as later-onset Parkinson’s, younger people may experience different challenges, such as managing work, family life, and financial planning alongside their diagnosis.

An estimated 1 in 20 people with Parkinson’s are under 50 in the UK. Genetic factors are more likely to play a role in younger individuals, and progression can vary significantly.