Parkisonism
Central Nervous System Conditions
G20/G21.0-4/G21.8-9/G22
DESCRIPTION
Parkinsonism is a syndrome that affects the nervous system and the parts of the body controlled by the nerves. It may be characterised by tremor, rigidity, stiffness, slow movements and postural disturbances. It may be primary, i.e. Parkinson’s disease, or secondary, i.e. drug-induced, or due to uncommon disorders that may initially resemble Parkinson’s disease.
Patients and caregivers may report:
- A tremor, or rhythmic shaking, which usually begins in a limb, often the hand or fingers.
- Slowed movement (bradykinesia), for example steps may become shorter as they walk and it may be difficult to get out of a chair.
- Decreased ability to perform unconscious movements, including blinking, smiling or swinging their arms while walking.
- Speech changes such as slurring or hesitation in speaking.
- Difficulty in writing.
The objective of treatment is to:
- minimise disabling symptoms
- prevent complications and avoid serious drug-induced side effects
GENERAL MEASURES
All patients demonstrating signs and symptoms of parkinsonism should be referred to a medical practitioner for assessment and treatment.
REFERRAL
- Patients suffering from motor difficulties should be referred for general supportive therapy and advice about lifestyle modification, and multidisciplinary rehabilitation to optimise their functioning.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4_Version 1.0_26 May 2025
Chapter 15: Central Nervous System Conditions_15.3 Parkinsonism
ICD-10 codes
- G20Parkinson's disease
- G21.0Malignant neuroleptic syndrome
- G21.1Other drug-induced secondary parkinsonism
- G21.2Secondary parkinsonism due to other external agents
- G21.3Postencephalitic parkinsonism
- G21.4Vascular parkinsonism
- G21.8Other secondary parkinsonism
- G21.9Secondary parkinsonism, unspecified
- G22Parkinsonism in diseases classified elsewhere