Parkinsonian Features: What They Are, What Causes Them, and How They're Managed

When someone moves slowly, has shaky hands, or struggles to start walking, they may show parkinsonian features, a group of movement symptoms that resemble Parkinson’s disease but can come from many different causes. Also known as parkinsonism, these signs include tremors, stiff muscles, slowed movements, and trouble with balance—not just in Parkinson’s disease, but also after certain medications, strokes, or brain injuries. Many people assume these symptoms always mean Parkinson’s, but that’s not true. In fact, up to 25% of older adults with parkinsonian features don’t have the classic neurodegenerative form. The real cause? Often something simpler—and treatable.

One of the biggest culprits behind parkinsonian features is drug-induced parkinsonism, movement problems triggered by medications that block dopamine in the brain. Common offenders include older antipsychotics like haloperidol, some anti-nausea drugs like metoclopramide, and even certain antidepressants. These drugs don’t cause Parkinson’s, but they mimic it. The good news? Stopping the drug often reverses the symptoms within weeks. Another cause is vascular parkinsonism, damage from small strokes that affects movement pathways. This type usually hits the lower body first—making walking hard, but leaving the hands less affected. Then there’s multiple system atrophy, a rare, progressive brain disorder that looks like Parkinson’s but gets worse faster. It’s harder to treat and needs different management.

What sets true Parkinson’s apart? It’s not just the symptoms—it’s how they respond. People with Parkinson’s often improve with levodopa, a drug that replaces lost dopamine. But those with drug-induced parkinsonism rarely do. And unlike Parkinson’s, which starts on one side of the body, vascular or drug-induced parkinsonism often hits both sides evenly. Diagnosing the right cause means checking your meds, running brain scans, and sometimes waiting to see if symptoms fade after stopping a suspect drug. It’s not always quick, but it’s critical. Mistaking drug-induced parkinsonism for Parkinson’s can lead to unnecessary treatments, while missing multiple system atrophy can delay crucial care.

What you’ll find below are real, practical guides on how these symptoms show up, what drugs can trigger them, how to tell them apart, and how to manage them safely. From understanding why your blood pressure pill might be making you stiff, to learning how to track tremors at home, these posts give you the facts you need—no jargon, no fluff. Whether you’re dealing with these signs yourself or helping someone who is, you’ll walk away knowing what to ask, what to watch for, and what to do next.