Re: parkinson's

Posted By CCF Neurology MD on September 05, 1997 at 04:53:52:

In Reply to: parkinson's posted by Dianne perez on September 04, 1997 at 15:32:21:







: My brother has recently been diagnosed (tenatively) with Parkinson. He is experiencing an occasional numbness in the left arm that
at times can affect his typing. It sometimes dangles when he walks, although when he notices it, he can stop it from happening by concentrating
on it. The numbness sometimes is felt also in his left leg. There is a mild temor in the left hand. He is seeing a doctor at Fairview Park in cleveland and was given
L-dopa or some form of it to see if his symptoms get better which he was told was indicative of parkinson.He had an MRI to rule out tumors.
My concern is that this is only the second time he saw this doctor and I thought the diagnosis was rather fast and perhaps his symptoms could be due to something else.
He is a healthy individual, takes blood pressure pills to lower his pressure, has had occasional gout and the symptoms are still rather mild. He is only 42 years old.
No one else in the family has neurological disorders. There is some heart attack and bypass surgeries but these are with older relatives in their 60s and 70s.
I have Crohn's disease. Diabetes run in the family.
I am trying to convince him to see a specialist (for a second opinion) at the cleveland Clinic, where you notice I also work ( in Molecular Cardiology).Are the symptoms that prognostic of
Parkinson's or could it be due to something else that the doctor hasn't thought of. I would appreciate a referral to the best doctor and any info to pursuade him to see
someone here.



    
Dear Dianne:
I suggest that you brother see Dr. R. Stanley Burns, Dr. Richard Lederman, or Dr. Patrick Sweeney at the Cleveland Clinic for a second opinion, if he wishes to have one. Each of them has a very extensive experience in seeing and treating patients with Parkinsons disease and related conditions.
To answer some concerns you have:
The diagnosis of Parkinsons disease (PD) is clinical, and can often be fairly reliably made at first visit even in a relatively mild or early case. Several conditions can, indeed, be confused diagnostically with PD. These include other related neurodegenerative disorders such as multiple system atrophy and progressive supranuclear palsy, drug and toxin induced parkinsonism, and essential tremor, amongst others. Parkinsons disease can occur at ages less than 40, and it more likely than not does NOT run in families.
While Levodopa/Sinemet is the most effective drug for controlling symptoms and signs, current thinking favors the use of other medications in early or mild cases.