What You Need to Know About Vascular Parkinsonism

It mimics Parkinson’s disease, but is a very different condition.

Medically reviewed in July 2022

Former President George H.W. Bush went skydiving to celebrate his 85th birthday in 2009. Less than three years later, his son Jeb revealed that he was confined to a wheelchair (though he still managed to jump again for his 90th). 

The reason? A Parkinson’s disease-like condition known as vascular parkinsonism (VP). The movement issues from VP are caused by small strokes in a section of the brain called the basal ganglia, which controls movement, among other functions.  

VP versus Parkinson’s 
While the two conditions share a number of symptoms, there are important differences. Parkinson’s typically progresses gradually, but because strokes can happen suddenly, VP can appear or worsen suddenly. VP most often affects the lower body. There may be other signs of stroke with VP, such as slurred speech or cognitive impairment, and sometimes incontinence. 

Risk factors 
Because VP is essentially a series of strokes, risk factors for VP are the same as risk factors for stroke. They include: 

  • Older age 
  • Being male 
  • High blood pressure 
  • Diabetes 
  • History of stroke 
  • Peripheral vascular disease 
  • Smoking 
  • High cholesterol 
  • Obesity 

Diagnosis and treatment of VP 
Both Parkinson’s and VP can be difficult to diagnose, as there are no blood tests for either. However, unlike Parkinson’s, evidence of VP can often be detected by an imaging test like a CT scan or MRI. Abnormal brain scans are present in nearly all VP cases, and will often show evidence of multiple small strokes in the basal ganglia.  

Since VP doesn’t function the same way as Parkinson’s, it doesn’t respond to the same treatments. Parkinson’s treatment usually involves drugs that can be converted to dopamine, mimic dopamine or stop the destruction of dopamine. VP, on the other hand, is usually treated by trying to limit stroke and heart disease risk. Exercise, quitting smoking, a proper diet, controlling blood pressure and diabetes, and certain medications that help prevent blood clots or lower cholesterol can all reduce the chances of more strokes. 

Image credit: Ytoyoda, Wikimedia Commons 

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