Parkinsonism

The classic triad of parkinsonism includes bradykinesia (slowness of movement and speech), rigidity (increased resistance of the arms, legs, neck, and torso to passive movement), and tremor (typically in the hands or arms, present at rest, but not with movement). Parkinsonism can be a delayed consequence of multiple concussions. It is not likely to be caused by a single concussion. Parkinsonism is sometimes, but not always part of chronic traumatic encephalopathy. If the patient has parkinsonism, the first priority is to determine whether there is a reversible cause, most commonly a medication. If the patient has parkinsonism not due to a reversible cause, consider pharmacological treatment with carbidopa–levodopa or a dopamine agonist. Also refer to physical therapy for balance training and education on how to reduce fall risk. Importantly, multiple concussion-related parkinsonism is not the same as Parkinson’s disease. Injury-related parkinsonism does not usually get worse over time and can stay stable over decades.