I was diagnosed in 2018 with Parkinsonism. My question is: is it true that if you are hyperactive, you have too much dopamine, and if you have too little, you become shaky? I’m also wondering what the difference is between Parkinson’s disease and parkinsonism – which is the milder of the two? There’s clearly a difference, because I’m not eligible for insurance cover as I have parkinsonism rather than Parkinson’s, and I don’t get the blue card for dental care either?

Yes, hyperkinesia only occurs once you’ve had the condition for a few years and is linked to excessive dopamine stimulation. If you have too little dopamine, you experience a wide range of symptoms, of which tremors/shaking are just one. These can also include, for example, slowness, stiffness, sluggishness of movement and a long list of ‘non-motor’ symptoms. The typical motor symptoms of Parkinson’s (slowed and reduced movement, muscle stiffness and tremors at rest) are referred to as parkinsonism. This term simply means that a person has symptoms similar to those of Parkinson’s disease or another similar condition; it is therefore not a diagnosis but merely a description of the symptoms. The other conditions (e.g. MSA, PSP, CBS, vascular parkinsonism) are collectively referred to as ‘atypical parkinsonism’, and if one is unsure which one it is, one can simply say ‘parkinsonism’. After five years of the condition, as in your case, it is usually possible to be a little more certain of the exact diagnosis, but it can still be difficult. In general, ‘common’ Parkinson’s disease is milder than the various atypical variants, partly because patients often respond well to medication for Parkinson’s disease. /Dag Nyholm