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Parkinson's Hereditary?
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Parkinson's Hereditary?

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
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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 (shaky).  I would have a good neurologist look at your shakey (shaky) hands if you are concerned.

Sincerely,

CCF Neuro MD
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Reference to Karen's shaky hands.  I started with the shaky tremors in my right hand this past May.  I went to a MD after approx. four weeks.  She stated it looked like Parkinsons but she didn't think so because I was only 41.  Since then I have seen a Neurolgist and had EEG, CT, MRI, and numerous other tests that I can't remember any longer.  They all came back normal as he stated.  He said it looks like Parkinsons but because I am as young as 41 therefore, it couldn't be.  I experience tremors most of time now.  I notice it more when I am very stressed or if I haven't eaten all day then the tremors goes out of control.  I experience slowness in speech.  I will be talking and all of a sudden the words will not come out.  It is very frustrating.  My neurologist just looked at me when I explained all my symptons and wouldn't say anything about them. He just told me I was fine.  Here it is Nov. already and I never got any answers to my condition.  My walking gets very slow at times and hard to pick up feet.  My back has been experiencing pain in the lower right side.  I am not sure if this is all related, but I sure wish you all the luck in finding a doctor who will listen and help you.  I am stuck because our insurance will only let me go to the neuerolgist I went to.  Also, they are the only ones in my area.  Good luck and if possible don't let the doctor brush you off.
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thanks for your comment.

CCF Neuro MD
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I posted the note reference Parkinson.  What do you think I should do next reference my tremors.  Like I said I had EEG, EMG, CT Scan, MRI, numerous blood work ups.  I have elevated blood pressure.  Its up and down alot.  I had it checked last Thurs. and it was 156/94.  I don't know what to do next reference the tremors.  My neurolgist kind of blew me off stating he didn't think it was Parkinsons because I am to young.  Any ideas what it could be.  The doctor was clueless.  All he wanted to do was put me on Inderal for Bloodpressure because he didn't know what to do for me.  Any suggestions would be greatful.  Alice
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Avatar_n_tn
Dear Alice:

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
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I am not sure I understand what your telling me.  What is essential tremors and what is ETOH?  I am not a regular drinker.  I have gone out with friends and have had some drinks but the tremors are the same as before.  I don't know where else to get a second opinon because the neurology clinic I went to is the only one around in this area and the insurance will not pay out of State doctors.  My husband has ECHO insurance.  I guess what my real question is will the Parkinson show up on any of the test I have undergone?  If so, then could it be to early in the stages to test positive?  Over the years I have been exposed to different chemicals through work and lived on different farms in Texas and in Illinois.  Could any of this make a difference?  I am so frustrated and confused.  Any helpful suggestions?



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Avatar_n_tn
Dear Alice:

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
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I am 38....luckily found a wonderful neurologist !   Second opinion....first symptoms (tremor in rt. hand only) beginning approx. 2 yrs ago. Mostly noticable when I tried to hold my hand still.  I paint (artwork) and I began having a difficult time steadying the brush for fine details...(that came and went 1 and 1/2 yr before seeking med. help.) then it was mostly the terrible cramps in my calves and feet that were waking me up at night 3 & 4 times a night. Tremors were almost constant by then and also affecting my left arm slightly...lower jaw and legs...occasionally.  I had pretty severe stiffness in my right arm and in my lower hips...when I would try to get up or down.  Also holding just a coffee cup...would hurt my rt. arm.
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)
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Avatar_n_tn
Dear Tambra:

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
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I have been treated for Parkinson's disease for about the past six years.  I take a combination of drugs (sinemet, eldepryl, permax and tasmar) which keeps me "normal" throughout the day, wearing off only in the evening or when I forget to take one or more of the combinations at the proper time (6:30, 9:30, 12:30, 3:30, 6:30.) The question is Tasmar.  I've had blood taken evey few weeks for the first year and now give it monthly to monitor liver functions.  I've heard about "Comtan" which I understand serves the same purpose as Tasmar, but doesn't require the monitoring.  I hate getting stuck as my veins are hard to find and it's always an ordeal.  Do you have any info on Comtan and would it make sense to switch?  Also what would be the effect if I just stopped the Tasmar?  Thank you
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Dear Mort:

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
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my mother has been diagnosed with pd six years ago she has taken sinimet 25/100 for the full 6 years she has developedin the last year severe headaches. she has been on tasmar and permax and comtan with no relief at one time she was taking up to 18 25/100 sinimets per day she has seen countless neurilogists on1/27/00 she seen a neurologist that has given her the impression that she does not have PD but that she has spasmodic torticollis as she has never little to no tremors but has always had leg pain and spasms for the six years what can you tell me about ST and do you think that we are on thr right track with her illness?
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Dear Bonnie:

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
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A related discussion, My mum has parkinsons was started.
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