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Neurology (Expert Forum)
Parkinson's Hereditary?
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Parkinson's Hereditary?
by Karen, Oct 09, 1999 12:00AM
My paternal grandmother had Parkinson's. Has this disease proven to be hereditary? I worry because I've always been very "shaky". My hands tremble sometimes, and have since I was young. I feel it may be related to blood sugar. I am now in my late 30's.
Also, I have a pain in the back of my head, left side, that is felt when I cough or sneeze, or bend over. This has been going on for 2 -3 weeks, without subsiding. Could this be related?
Thanks... K
Also, I have a pain in the back of my head, left side, that is felt when I cough or sneeze, or bend over. This has been going on for 2 -3 weeks, without subsiding. Could this be related?
Thanks... K
Doctor's Answer
by CCF Neuro[P] MD, RPS, Oct 10, 1999 12:00AM
Dear Karen:
The vast majority of cases of Parkinson Disease is not hereditary. Even in identical twin studies, most of the data suggests that something else is inducing this disease. There are a very small percentage that are thought to be inherited but this is a very small. You have more of a chance of coming down with this disease if you live in Kansas or another farming state than you do from getting this disorder from your father. I bet that when we finally know about the genetics of this disease is that it will be multifactoral. There is likely several genes that predispose the individual to getting Parkinson disease and then you need a couple of environmental factors also.
The classic early symptoms is tremor, resting tremor. This would be distinct from shakey. I would have a good neurologist look at your shakey hands if you are concerned.
Sincerely,
CCF Neuro MD
The vast majority of cases of Parkinson Disease is not hereditary. Even in identical twin studies, most of the data suggests that something else is inducing this disease. There are a very small percentage that are thought to be inherited but this is a very small. You have more of a chance of coming down with this disease if you live in Kansas or another farming state than you do from getting this disorder from your father. I bet that when we finally know about the genetics of this disease is that it will be multifactoral. There is likely several genes that predispose the individual to getting Parkinson disease and then you need a couple of environmental factors also.
The classic early symptoms is tremor, resting tremor. This would be distinct from shakey. I would have a good neurologist look at your shakey hands if you are concerned.
Sincerely,
CCF Neuro MD
CCF Neuro MD
Early 40's is not too young to get Parkinson's, just look at Michael J. Fox. It is uncommon but we have seen the disease in many 30-40. I would seek a second opinion. If your tremor is essential tremor, then indural would be helpful. Although not diagnostic, a dose of ETOH or a stiff drink and your tremor gets better, then you likely have essential tremor. But, I would get a second opinion and see if your tremor is not Parkinson tremor.
Sincerely,
CCF Neuro MD
ETOH is alcohol. Usually, an essential tremor will respond to alcoholic drinks. This is a unorthodox way of diagnosis. But we see that many patients will have used this way to control their tremors. I guess you are stuck. Parkinson's is basically a clinical diagnosis,or one of clinical exam by a neurologist. There are many clinical signs that are manifested as the disease progresses. The tremor is usually the initial manifestation, but not always. People who live in the midwest, especially farmers have a mild increased chance of coming down with Parkinson's.
Sorry, I wish there was something I could do.
Sincerely,
CCF Neuro MD
First diagnosis was ET (essential tremor) and he said cramping was due to stress. That I neeeded to USE my rt. arm more. (by the way I AM right handed...and PAINT and use my arm often...Also have four daughters and a granddaughter...which means doing their hair.....etc..etc... anyhow HE
prescribed valium.......and valium did nothing. Luckily my insurance allowed a second opinion.
Second opinion was from a specialist ...A movement disorder specialist. He deals with mostly PD patients. He said it was not ET....and that he wanted to try sinemet cr 50/200 twice a day to see if it helped.
IMMEDIATELY it did. The tremors subsided and the stiffness was gone...within a few days. HE called it Parkinsonism. (I was young but not impossible...I had the symptoms. cramps persisted and tremors occasionally so he increased the sinemet to three times a day. (I tried muscle relaxer flexeril but it did not work at all... )Now 6 mths after starting the sinemet I just went back to the neurologist again this past week. I began experiencing tremors again...and some tightness in my calves and feet. Cramps still also. He started me on Mirapex (low dosage to increase gradually over a 3 wk period} along with the sinemet cr.3 x's a day. ALREADY since Dec. 8.... Tremors are much much better! Still have some tightness in my calves and feet though.
I did notice however that prior to my menstrual cycle the tremors and cramping became worse. There were days I didnt think I would be able to get up. Very depressed and sad...and Could have just stayed in bed....Also if I am very physically tired or mentally upset...Symptoms worsen...I had also began having some balance difficulties...Making U turns...backing up from a small place...like a closet..Or stepping down from someplace..(ladder) backing up... and going around an object..like a table or car..I would hit the corner. walking thru doorways...I seem to be forever hitting one of my shoulders on it. It is like I cant balance walking thru it. However I have found that symptoms vary from person to person. My doctor did give me literature this last visit re: Parkinsons Disease.
Just a day in my life....
I am sorry for going on so long. I guess I just wanted to share my story. I pray you find help soon. Hang in there...Maybe you will soon get the chance to find someone to help you better!
Prayers
Good luck!
tambra :o)
Sorry to hear about your problem. It does sound like you have Parkinson's. I hope that the medication helps keep you functioning for a very long time.
Thanks for your comment.
CCF Neuro MD
Tolcopone is a COMT inhibitor used in Parkinson's while Comtan is an antihypertensive agent. The two are not really the same and since COMT inhibitors allow the dopamine agonist to be more available, I would stick with what your taking.
CCF Neuro MD
It is difficult for me to tell you. Parkinson's disease is a clinical diagnosis (there is no definitive test to say you have Parkinson's) and usually the constellation of signs and symptoms is diagnostic. There is this fringe group of patients that are a clinical delemmia as they do not present classic symptoms. Without examining your mother it is difficult for me to tell you one way or another. Usually the resting tremor that is usually greater on one side, the spasticity in a limb, the low voice, small handwriting, etc make the diagnosis. Some dystonias respond to dopamine medications. At one time we (at least some)thought that response to dopamine meds was an indicator of Parkinson's and the relatives of Parkinson's.
I think what you might need to do is get a second opinion from a Parkinson's expert. A spasmotic movement should not have the other entities that are co-morbid with Parkinson's (multiple extremities that are involved as with other central signs).
Sorry, I am not much help.
Sincerely,
CCF Neuro MD