Atypical Parkinson’s Disease: What It Is and What Causes It

Hearing the term “atypical Parkinson’s disease” (often called atypical parkinsonism or Parkinson’s-plus syndromes) can feel confusing and a little alarming. You might be thinking:

“Is this still Parkinson’s? Is it something different? Does it change my prognosis?”

In simple terms, atypical Parkinson’s conditions are neurological disorders that look similar to Parkinson’s disease on the surface—with stiffness, slowness, and balance changes—but behave differently over time and don’t respond to treatment in the usual way.

At Naples Brain Center, chiropractic neurologist and functional neurologist Dr. Darcy Dane works alongside your neurology team to focus on movement, balance, and overall brain function in both typical and atypical forms of Parkinsonism.

If you’d like a more personalized, brain-based plan, you can request a consultation with Naples Brain Center.

 

What Is Atypical Parkinson’s Disease?

“Parkinsonism” is the umbrella term for symptoms like:

  • Slowed movements (bradykinesia)

  • Muscle stiffness (rigidity)

  • Tremor

  • Postural instability and changes in gait

Parkinson’s disease is the most common cause of parkinsonism.

Atypical Parkinson’s disease refers to a group of less common, usually more rapidly progressive conditions that:

  • Have parkinsonism symptoms

  • Often respond poorly or only briefly to standard Parkinson’s medications

  • Tend to have additional features, such as early balance problems, early cognitive changes, or significant autonomic issues (like blood pressure or bladder problems)

Because they share many symptoms, atypical Parkinson’s conditions are often misdiagnosed as Parkinson’s disease in the early stages. Over time, the pattern of symptoms and response to treatment helps doctors clarify the diagnosis.

 

Common Types of Atypical Parkinson’s Disease

Most clinicians use “atypical Parkinson’s” or “atypical parkinsonism” to refer to several specific diagnoses, including:

  • Multiple System Atrophy (MSA)

    • Parkinsonism symptoms

    • Prominent autonomic issues (blood pressure dropping upon standing, urinary problems, erectile dysfunction)

    • Possible problems with coordination (cerebellar signs)

  • Progressive Supranuclear Palsy (PSP)

    • Early problems with balance and falling (often backward)

    • Difficulty moving the eyes up or down

    • Stiffness and slowness that may not improve well with medication

  • Corticobasal Degeneration / Corticobasal Syndrome (CBD/CBS)

    • Asymmetric stiffness, clumsiness, or dystonia (often one arm or leg)

    • “Alien limb” phenomenon in some cases (a limb that seems to move on its own)

    • Difficulties with complex movements or use of the affected limb

  • Dementia with Lewy Bodies (DLB)

    • Parkinsonism symptoms

    • Early and significant cognitive changes

    • Visual hallucinations and fluctuations in attention and alertness

These conditions are not the same as typical Parkinson’s disease, although some can overlap with it or even evolve from it.

 

How Is Atypical Parkinson’s Different from Typical Parkinson’s Disease?

While only your neurologist can make or confirm a diagnosis, there are some features that may raise suspicion for atypical Parkinson’s disease rather than typical Parkinson’s:

  • Poor or limited response to Parkinson’s medication

  • Early falls, especially backward

  • Very early balance problems

  • Early autonomic symptoms, like severe blood pressure drop when standing, or significant bladder problems

  • Early cognitive changes or hallucinations

  • Very rapid progression compared to what’s expected

  • Unusual eye movement problems (especially difficulty looking down or up)

  • Marked asymmetry or “strangeness” in how one limb moves or feels

Again, having one of these signs does not automatically mean a person has atypical Parkinsonism, but it may prompt the neurologist to look more closely at the pattern.

 

What Causes Atypical Parkinson’s Disease?

Atypical Parkinson’s conditions are neurodegenerative disorders, which means certain brain cells gradually become dysfunctional and die over time.

While each condition is different, some common themes include:

  • Abnormal protein accumulation in the brain

    • For example, certain disorders are associated with abnormal buildup of proteins like tau or alpha-synuclein.

  • Damage to specific brain networks

    • Areas controlling movement, balance, eye movements, autonomic function, and cognition can all be affected.

  • Complex, not-fully-understood origins

    • Genetics, environment, aging, and other factors may all play a role, but in most people, there’s no single identifiable cause.

At this time, there is no known cure and no proven way to stop these conditions entirely. However, symptom-focused treatment, rehabilitation, and brain-based therapies can make a real difference in comfort, function, and quality of life.

 

How Is Atypical Parkinson’s Disease Diagnosed?

There isn’t one simple “yes or no” blood test or scan. Diagnosis is usually based on:

  • Clinical history – which symptoms appeared first, and how they’ve changed over time

  • Neurological exam – assessing movement, balance, reflexes, eye movements, cognition, and more

  • Response to medication – does dopaminergic therapy help a lot, a little, or not at all?

  • Imaging or lab tests when indicated – mostly to rule out other causes

Sometimes a person is initially told they have Parkinson’s disease, and later the diagnosis is revised to an atypical form as the pattern becomes clearer. That can be upsetting, but it can also help guide more realistic planning and tailored support.

 

Treatment and Support: What Can Be Done?

While atypical Parkinson’s diseases don’t usually respond as strongly to standard Parkinson’s medications, symptom management is still very important and often includes:

  • Medications to help with stiffness, slowness, or specific symptoms

  • Physical, occupational, and speech therapy

  • Strategies for swallowing, communication, and mobility

  • Management of autonomic symptoms (such as blood pressure or bladder issues)

  • Support for mood, sleep, and cognition

Alongside your medical care, a functional neurology approach can focus on how your brain and body function in real time and how to make the most of your current abilities.

At Naples Brain Center, this may involve:

  • Gait and balance training to reduce fall risk

  • Visual and vestibular (inner ear) exercises to support coordination and stability

  • Targeted movement training designed to stimulate specific brain networks

  • Task-specific strategies for getting out of chairs, turning in bed, and navigating everyday environments

  • Caregiver education on safe transfers and movement support

The goal isn’t to replace your neurologist—it’s to add another layer of support focused on practical function, safety, and quality of life.

Want to explore whether this kind of care could help you or a loved one? Request a consultation with Dr. Dane at Naples Brain Center.

 

When to Talk to a Specialist

You may want to ask your neurologist specifically about atypical Parkinson’s disease if:

  • You’ve been told you have Parkinson’s, but symptoms are progressing faster than expected

  • You’ve had very early falls or balance problems

  • There’s little or no benefit from Parkinson’s medication

  • You have early, significant changes in thinking or visual hallucinations

  • You’ve been told your symptoms “don’t quite fit” classic Parkinson’s disease

Getting clarity—whether the diagnosis is typical Parkinson’s or an atypical form—allows you and your care team to:

  • Plan realistically

  • Prioritize safety and support

  • Tailor therapies to your specific challenges

Parkinson’s Video Resource Center

For ongoing education and support, here’s a Parkinson’s video resource center you can return to and share with loved ones:

Moving Forward with Support

An atypical Parkinson’s diagnosis can feel heavy, but you are not without options. While we can’t yet cure these conditions, there is much that can be done to:

  • Support safer movement and balance

  • Preserve independence for as long as possible

  • Improve daily comfort and confidence

  • Help you and your family understand what’s happening and how to adapt

If you’re in or near Naples and looking for a more comprehensive, brain-based approach to movement and brain health, Naples Brain Center is here to help.

Take the next step and request a consultation with Naples Brain Center to discuss your situation and potential treatment options.

 

Frequently Asked Questions About Atypical Parkinson’s Disease: What It Is and What Causes It

What’s the main difference between typical Parkinson’s and atypical Parkinson’s disease?

Typical Parkinson’s disease usually develops gradually, often responds reasonably well to standard Parkinson’s medications (at least for a time), and tends to follow a somewhat more predictable course. Atypical Parkinson’s conditions, by contrast, often progress faster, respond poorly or only briefly to medication, and include additional features such as early falls, prominent autonomic problems, unusual eye movement issues, or early cognitive changes. Only a neurologist can make or refine the diagnosis, but noticing these differences can help guide more accurate evaluation and more realistic planning for care and support over time.

Why is atypical Parkinson’s disease sometimes misdiagnosed at first?

Early on, atypical and typical Parkinson’s disease can look very similar: stiffness, slowness, tremor, and changes in gait or posture. Doctors usually start with the most common diagnosis—Parkinson’s disease—and see how symptoms and treatment response evolve. Over time, certain patterns may emerge, such as very early falls, poor response to medication, unusual eye movement problems, severe early autonomic issues, or early dementia. These clues can lead the neurologist to consider an atypical form instead. The diagnosis is often refined over months or years, as more information becomes available.

Is atypical Parkinson’s disease always more serious than typical Parkinson’s?

Atypical Parkinson’s conditions tend to be more rapidly progressive and can cause significant disability sooner, so in that sense they are often more serious. However, “serious” can mean different things to different people. While the overall outlook may be less favorable compared to typical Parkinson’s, there is still a great deal that can be done to support safety, function, comfort, and quality of life. Early planning, rehabilitation, brain-based therapies, and caregiver support can all help the person live as fully and safely as possible, even in the face of a tough diagnosis.

Can atypical Parkinson’s disease be cured or reversed?

At this time, there is no known cure for atypical Parkinson’s disease, and these conditions are considered neurodegenerative. That means certain brain cells gradually become damaged and do not regenerate in a way that completely restores normal function. However, that does not mean nothing can be done. Symptom-focused treatments, medications, rehabilitation therapies, and functional neurology approaches can often reduce complications, improve daily function, and enhance comfort. The goal becomes supporting the person’s best possible function at each stage, rather than chasing a cure that does not yet exist.

How can family members and caregivers best support someone with atypical Parkinson’s disease?

Caregivers can help most by combining understanding, practical support, and teamwork with the medical and rehabilitation providers. This may include helping with mobility, ensuring a safe home environment, monitoring changes in thinking or behavior, and attending appointments to hear recommendations firsthand. Learning safe ways to assist with transfers, using equipment correctly, and respecting the person’s dignity are vital. Emotional support—patience, reassurance, and shared moments of connection—matters as much as physical help. Caregivers should also seek their own support and respite; taking care of themselves is essential to sustaining care over time.