Thus dopamine replacement doesn't resolve the many problems associated with these disorders. Although early on these disorders may be difficult for doctors to tell apart, as time goes on they develop certain distinguishing features. They all share the unfortunate characteristic of responding poorly to anti-Parkinson medications. Disturbances in speech, eye movement as well as muscular rigidity occur. OPCA may present with rigidity, resting tremor, slowness of muscle movement, a fixed facial expression and a shuffling gait which are typical of Parkinson's.
Most patients become wheelchair bound within a few years of onset.
Swallowing can also become a major problem putting the patient at risk of choking and developing pneumonia. This disorder can be inherited. Often this is hard to distinguish from Parkinson's Disease. The typical Parkinsonian rest tremor occurs less commonly. An MRI can sometimes identify changes in the brain that can suggest this diagnosis.