Parkinsonism?

    
      Re: Parkinsonism?
    


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Posted by ccf neuro M.D. on April 18, 1997 at 15:37:51:

In Reply to: Parkinsonism? posted by Helen on April 16, 1997 at 04:35:20:

: Could slowing of speech and walking, great effort needed doing either, along with parasthesia in hands and inability to manipulate things be signs of Parkinsonism? No shaking / tremor signs present and I'm only 33.
  Is there a specific diagnostic test for Parkinsonism? - at the moment it has been suggested as a possible reason for problems.
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Helen, although your symptoms are potentially compatable with early Parkinson's disease, which, interestingly, sometimes presents with odd sensory symptoms before the more classic symptoms evolve, there are a number of other possibilities, particularly in someone as young as yourself. If you have not already had an MRI scan of your brain with contrast to rule out the possibility of a tumor, small strokes, or inflammatory disease or infiltrating disease (some examples include central nervous system lymphoma, vasculitis), you probably should. A spinal tap to look for some of these diseases may also be helpful. If these were unrevealing, it is possible you could have Parkinson's disease or one of its cousins. Parkinson's disease itself is clinically diagnosed--- there is no "test" per se for it other than symptoms and a thorough neurologic examination by a neurologist to exclude other possible explanations. If one finds an abnormaility in the areas of the brain responsible for generating and initiating movement, this, in fact, suggests another diagnosis, and makes Parkinson's disease much less likely. Sometimes a trial of medications used to treat Parkinson's disease such as levodopa/carbidopa (Sinemet), Artane, amantidine, pergolide (Permax) or bromocriptine, may be useful as typical Parkinson'e disease is helped by these things and the LACK of a response to them would again suggest an alternative diagnosis. If you have not already seen a neurologist at a large teaching hospital near you, I would HIGHLY recommend doing so very PROMPTLY, as you would not want to miss out on treating potentially treatable disease process that might imitate Parkinson's disease prior to them causing permanent brain damage. The lack of shaking or tremor does not at all exclude the diagnosis of Parkinson's disease--- many patients with the disease do not have tremor, especially early on. Tremor is the most difficult to treat of all Parkinson's symptoms. Slowness of movement and stiffness, on the other hand, usually respond better to
medications used to treat the disease. I hope this information is helpful. If you are near the Cleveland area, Dr. Stanley Burns is our chief specialist in Parkinson's disease and movement disorders. If you wished to be seen by him, an appointment could be arranged by calling 216-444-5559 (or 1-800-223-2273 extension 45559).