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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Possible Dx??Forum: Neurology Forum
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I have been suffering with numerous neurological symptoms for the past 6 years, but as of yet have received no diagnosis. In reading about PD, I have found serveral sypmtoms that are common to me. They include - weakness, fatigue, stiffness when starting to walk, difficulty getting out of a chair, hand tremor, myoclonus day & night, chronic constipation for which they can find no other cause, bladder urgency and frequency, and shortness of breath after minimal physical exertion. I realize that these are symptoms common to many neurological diseases, but wonder if it might be worthwhile to look at PDd as a possible dx? Are there any specific tests I can push for? A lot has already been done, but maybe needs to be redone? I will be seeing a new doctor in January. I am 41 years old, and have a maternal aunt with PD. Thanks for your help. = Unfortunately, it is impossible from the list of symptoms to gather whether or not you have PD. Indeed, the symptoms listed can be part of PD as well as many other diseases, but precision in details is necessary. If you have been having symptoms for 6 years and you are 41, it seems less likely that this is PD. It is certainly possible for someone to get PD at a young age (35) - witness Michael J Fox. However, usually the progression by 6 years is such that it is no mystery even if it started out as one. Comment: if you are over 60 when you get PD, there is hardly any genetic factor in the origin of your disease. If you are young (30s or 40s), you have more chance of a positive family history, and the argument is that there may be a bit of a genetic component. Your data is interesting, but of course, not conclusive. The hand tremor is an important observation. Is this at rest or with maintenance of posture or upon executing manual tasks? There are very particular characteristics of PD tremor which can be clues. On the other hand, I've seen enough people with PD who don't have the typical tremor - it just means the whole thing has to be integrated by someone in the proper context. If you suspect PD, see a movement disorders specialist. Ordinarily, a general neurologist (in some cases a general practitioner) can make the diagnosis, but if you've had mystery symptoms for 6 years, you want someone who has seen zillions of PD patients. You want someone who can tell you: This IS or this IS NOT Parkinson's disease. That said, of course, even movement disorders experts can get stumped. Usually, however, the difficulty is in distinguishing among the PD look-alikes (such as MSA, PSP, DLB, CBD, etc, stuff many doctors have not even heard of) rather than between PD and, say, stroke or MS. I hope this helps. CCF MD mdf.
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