‘Parkinson plus’ disorders

The ‘Parkinson plus’ disorders are multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome and Lewy body dementia. No specific drug therapy is available. Some patients with ‘Parkinson plus’ disorders may respond to levodopa, especially in the early stages of disease. However, the response is not usually as pronounced as in idiopathic Parkinson disease. Most therapy is directed at treating autonomic dysfunction (see advice on orthostatic hypotension and bladder dysfunction) or dystonia (botulinum toxin type A injections).