COULD THIS BE PARKINSON'S DISEASE?

  For about 5 years I have been suffering from
  symptoms which I have recently learned, "could" be
  consistent with symptoms of early stage Parkinson's
  Disease: Stiffness of my neck, back and shoulders,
  increasing balance difficulties, and most recently
  my toes and fingers (left side) have been moving
  (or twitching) on their own. I have also begun to
  have some actual muscle trembling, although it is
  infrequent at this point. My left arm does not
  swing when I walk, either, unless I am aware of
  it...then I can MAKE it swing. In addition, I also
  suffer from mild to moderate depression, constant
  fatigue and difficulty with sleep.
  
  I am 38 years old and recently have taken several
  bad falls. I made an appointment with a Neurologist
  in my area (he was NOT a Movement Disorder
  Specialist..and see's primarily older PD
  patients)..and the appointment did not go well. I
  believe it was due to my age, but the moment he
  heard me utter the word "depression", his eyebrow
  went up and he suggested I get a good Psychiatrist.
  I have suffered from depression for almost 10
  years, but these other symptoms have troubled me
  for only about half that time (5 years).
  I feel that I am currently in LIMBO...and do not
  know whether or not to pursue the PD angle. I have
  heard that it is common for a younger PD patient
  (whose symptoms may not be as obvious as an older
  patient)..to have a large amount of difficulty
  getting a doctor who WILL pursue and try to rule
  out Parkinson's. Is this true, and should I try
  again? The symptoms are becoming more difficult for
  me to live with...especially the rigidity in my
  back. Thank you for your time.

[CCF Neuro[P] MD RPS]

_
Dear Scott:
Sorry to hear about your symptoms.  Early onset Parkinson disease is a rare finding, although Michael J. Fox has given us an example that it is possible.  Actually, your symptoms have some of the flavor of Parkinson's but not the usual presentation.  Usually, it begins with a resting tremor that has a characteristic rate and rhythm and describe as a "pill rolling" tremor.  The tremor will vanish with action/movement.  It is usually asymmetrical.  There is also a facial "masking" that occurs early.  The symptoms then become bilateral with the tremor, and a shuffling gait becomes prominent.  At this point the postural reflexes are normal.  The third stage of the disease is loss of postural reflexes.  The disease progresses with the patient having difficulty getting out of chairs etc.  One also sees a change in speech that is very striking as the disease progresses.  There will be unnatural pauses, and decrease in modulation of emotion.  
Putting these symptoms together with your description would lead me to think that you do not have Parkinson's disease.  I would try and figure out what the etiology of your problems might be.  A good thorough examination by a neurologist would be a starting point.
Good luck with finding the etiology of your illness.
Sincerely,
CCF Neuro[P]MD