However, the symptoms may be difficult to assess, particularly in the elderly. For example, the tremor may not appear when the person is sitting quietly with the arms in the lap. The posture changes may be similar to osteoporosis or other changes associated with aging. The lack of facial expression may be a sign of depression . Examination may show increased muscle tone, tremors of the Parkinson's type, and difficulty initiating or completing voluntary movements.
Reflexes are usually normal.
Tests are not usually specific for secondary parkinsonism but may be used to confirm or rule out other disorders that may cause similar symptoms. The treatment is aimed at control of symptoms. If the symptoms are mild, no treatment may be required. If the condition is caused by a medication, the benefits of the medication may be weighed against the severity of symptoms. If appropriate, medications may be stopped or changed by the health care provider.