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Parkinsons Disease and Parkinsonism Are They Really the Same Disease From Causes to Treatments

Feeling changes in your body as you age is a natural part of life. However, when you experience symptoms such as hand tremors, body stiffness, or difficulty walking that cannot be simply dismissed as aging, worry is inevitable. Especially when the name "Parkinson's" is mentioned, many people experience confusion with vague fear: 'Is this symptom Parkinson's disease, or is it another problem?' Although Parkinson's disease and parkinsonism share similar names, they often show important differences in causes and treatment approaches. Through this column today, we aim to clearly resolve those questions.

💡 Core Answer "What is the difference between Parkinson's disease and parkinsonism?" The biggest difference is the cause. ① Parkinson's disease is an idiopathic disease caused by the damage of nerve cells in a specific part of the brain. ② Parkinsonism refers to cases where symptoms similar to Parkinson's disease appear due to other causes such as drug side effects, stroke, or encephalitis. ③ Dalimchae Korean Medicine Clinic helps recover brain function and improve symptoms through autonomic stabilization treatment.

Parkinson's disease is a progressive neurodegenerative disease that occurs when nerve cells in a specific part of the brain, especially the substantia nigra which produces dopamine, are progressively damaged. Dopamine is an essential neurotransmitter that smoothly regulates movement in our body, and as this dopamine becomes deficient, motor symptoms such as hand tremor (tremor), body stiffness (rigidity), slowed movement (bradykinesia), and postural instability appear. Parkinson's disease is known to be caused by a complex interaction of genetic and environmental factors, but the exact exact cause of onset has not yet been clearly elucidated.

Parkinsonism is a term encompassing cases that show motor symptoms similar to Parkinson's disease (tremor, rigidity, bradykinesia, postural instability) but whose causes differ from Parkinson's disease. In other words, "parkinsonism" can be understood as a 'symptom complex' appearing due to various causes rather than the name of a specific disease.

The most common causes of parkinsonism include:

• Drug-induced parkinsonism: Occurs by suppressing dopamine function due to side effects of certain antipsychotic drugs or gastrointestinal drugs.
• Vascular parkinsonism: Occurs when a specific part of the brain is damaged due to stroke or cerebrovascular disease.
• Atypical parkinsonism: Diseases similar in symptoms to Parkinson's disease but with different prognosis or treatment response, such as Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), and Corticobasal Degeneration (CBD).
• Encephalitis, brain tumor, trauma, etc.: Cases where symptoms similar to Parkinson's disease appear due to problems in the brain itself.

The most important difference is the location of the brain lesion and the cause of occurrence. Parkinson's disease occurs due to a specific cause—damage to dopamine nerve cells in the substantia nigra—while parkinsonism presents symptoms similar to Parkinson's disease due to various causes such as drugs or other brain diseases. Therefore, appropriate treatment is difficult without accurate diagnosis, so when symptoms appear, it is important to visit a medical institution for differential diagnosis. In this process, oriental medical institutions such as Incheon Parkinson's Korean medicine clinics can also diagnose and approach symptoms from various perspectives.

In the early stages, symptoms of Parkinson's disease are very subtle, making them easy to mistake for simple aging or fatigue. However, the following non-motor symptoms and subtle motor symptoms begin to appear gradually, and it is important not to miss these signals and cope with them early.

• Non-motor symptoms:
  • Olfactory decline: Inability to smell well.
  • Constipation: Chronic constipation appears along with digestive function decline.
  • Sleep disorders (REM sleep behavior disorder): Acting out dream contents or severe snoring/talking in sleep.
  • Depression, lethargy: Feeling depressed or lacking motivation for no special reason.
  • Autonomic nervous system symptoms: Orthostatic hypotension (dizziness when standing up), indigestion, frequent urination, etc.
• Motor symptoms (often starting in one arm and leg in the early stages):
  • Hand tremor (tremor): "Resting tremor" where hands tremble when resting quietly is characteristic. It starts subtly at first.
  • Body stiffness (rigidity): Feeling of stiffness and dulled movement in limbs or torso.
  • Slowed movement (bradykinesia): Everyday actions like washing or dressing become slow, and facial expression changes become less, making one look expressionless.
  • Postural instability: Difficulty maintaining balance and unsteady gait.

Since these symptoms can also appear from other causes even if it is not Parkinson's disease, professional diagnosis and consultation are essential if multiple symptoms appear complexly and gradually worsen.

Although motor symptoms due to dopamine deficiency are widely known in Parkinson's disease, in fact, more than 90% of Parkinson's patients experience non-motor symptoms together, which often appear before motor symptoms. Many of these non-motor symptoms are deeply related to functional abnormalities of the autonomic nervous system. Autonomic nerves automatically regulate essential life-maintaining functions such as digestion, heartbeat, body temperature regulation, and sleep in our body, and as Parkinson's disease progresses, problems also occur in this autonomic nervous system.

Dalimchae Korean Medicine Clinic Incheon Branch considers the balance of the autonomic nervous system important. The autonomic nerves of our body are like a main circuit breaker switch that creates an environment where the brain can rest. If this switch breaks, the brain remains in a constant overload state, which can further accelerate degenerative changes in the brain. In particular, constipation, indigestion, orthostatic hypotension, sleep disorders, and depression common in Parkinson's patients are all representative results of autonomic functional decline, and these symptoms significantly lower quality of life and adversely affect disease progression.

Although Parkinson's disease is a disease without post-treatment management methods yet in modern medicine, various treatments are being researched to alleviate symptoms, delay progression, and improve quality of life. In Korean medicine, Parkinson's disease is approached not simply as a problem of a specific neurotransmitter, but by identifying the fundamental causes as systemic Qi and blood circulation imbalance, weakening of organ function, and autonomic nervous system confusion due to excessive stress or aging.

Korean medicine treatment focuses on improving non-motor symptoms such as constipation, sleep disorders, depression, and dizziness, as well as motor symptoms such as tremor, rigidity, and bradykinesia in Parkinson's patients. In particular, it focuses on restoring autonomic balance to create an environment where the brain can rest and recover.

An clinical study published in 2021 in The Journal of Korean Medicine Rehabilitation reported that as a result of parallel herbal medicine and acupuncture treatment for 12 weeks targeting 30 Parkinson's patients, the UPDRS (Unified Parkinson's Disease Rating Scale) score, a motor symptom evaluation index, significantly improved from an average of 32 points before treatment to 25 points after treatment (p<0.01). In particular, patients' activities of daily living performance improved, and sleep quality and constipation symptoms also tended to improve. The researchers concluded that regarding these results, Korean medicine treatment can have a positive effect as a complementary role to dopamine drug therapy for overall symptom relief and quality of life enhancement in Parkinson's patients. These studies suggest that Korean medicine approaches can contribute to improving motor and non-motor symptoms in Parkinson's patients.

Based on these data, Dalimchae Korean Medicine Clinic proceeds with treatments that help patients regain healthy movement and life vitality on their own by recovering brain autonomic balance while minimizing non-motor symptoms and drug side effects that cannot be solved by medication alone. Lowering nervous system heat and creating an environment where the brain can rest—in Korean medicine, this is called Suseunghwagang—is an important treatment principle that goes beyond simply suppressing symptoms to help the body exert self-healing power.

Check how many of the following questions apply to you. (Please check based on symptoms within the last 6 months.)

1. Do you have tremors in your hands, arms, or legs when resting quietly?
2. Do you feel your body is stiff and your movements slower than before?
3. Have everyday actions like washing, eating, and dressing become clumsy and time-consuming?
4. Is there a feeling of dragging your feet or reduced stride when walking?
5. Is your gait unsteady and do you have difficulty balancing, almost falling?
6. Do people tell you your facial expression has become less expressive or your face looks stiff?
7. Have gastrointestinal disorders such as indigestion, chronic constipation, and reflux esophagitis worsened?
8. Do you talk or act out dream contents severely during sleep?
9. Are you frequently dizzy, and especially severely dizzy when standing up from a sitting position?
10. Are you frequently depressed or lethargic for no special reason?

Judgment Criteria:

• If 3 or more apply: Suspicion stage of Parkinson's disease or parkinsonism. Since the possibility of autonomic imbalance is high, consider professional diagnosis and complex Korean medical treatment.
• If 5 or more apply: This is a stage requiring immediate precise diagnosis and treatment. We recommend visiting Dalimchae Korean Medicine Clinic Incheon Branch, a Songdo autonomic medicine clinic, for detailed consultation.

Q. Is post-treatment management possible for Parkinson's disease? A. To date, Parkinson's disease is known as a progressive disease where post-treatment management is difficult. However, through appropriate treatment and management, symptoms can be effectively controlled and the disease progression speed slowed to significantly improve quality of life.

Q. Can parkinsonism also be treated with Korean medicine? A. Yes, parkinsonism can also help alleviate symptoms through Korean medicine treatment depending on the cause. Especially in cases caused by drug side effects, Korean medicine treatment can contribute to alleviating drug toxicity and regulating autonomic balance to reduce discomfort.

Q. What are initial symptoms other than hand tremor? A. Besides hand tremors, early symptoms can include olfactory decline where smells are not well recognized, chronic constipation, intense movements during sleep (REM sleep behavior disorder), depression, slowed movement, and stiff rigidity.

Q. Can herbal medicine be taken together with Parkinson's medication? A. In most cases, they can be taken together, but you must consult the responsible Korean medicine doctor to inform them of your currently prescribed medications and health condition to safely proceed with parallel treatment. Dalimchae Korean Medicine Clinic Incheon Branch closely grasps the patient's condition to establish an individual customized treatment plan.

Parkinson's disease and parkinsonism are not problems that can be solved by enduring. You do not need to turn a blind eye to body signals sent for a long time anymore. When approached in the right direction, body responds faster than you think. Bring the symptoms you are experiencing as they are. Dalimchae Korean Medicine Clinic will find the cause together.

Where life blooms. Herbal medicine is naturally Dalimchae Korean Medicine Clinic. Check similar symptoms to yours first through Dalimchae Korean Medicine Clinic website AI consultation!

This article is based on questions frequently received in the consulting room, and is health information organized together by Dalimchae medical staff. Medical Supervision | Brain & Autonomic Nervous System Treatment Standard, Dalimchae Korean Medicine Clinic Incheon Branch, Korean Medicine Doctor Min Ji-hong (Parkinson's Disease Column)