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MS vs Parkinson disease

Hi friends,,
Is there a relationship between Parkinson disease and multiple sclerosis. Particularly if there is a family history of Parkinson, does this mean that there is a higher probability that the other family members have MS?
Is there in this forum patients have a family history of Parkinson's disease?
8 Responses
987762 tn?1331027953
COMMUNITY LEADER
Hey Lyadaaa,

As far as i'm aware MS has no connection at all with true Parkinson's, having a family history of Parkinsons would mean there 'could be' a higher probability of Parkinsons because of the known genetic associations but i can't come up with any reason why there would be 'any' probability of other family members having MS instead....

Keep in mind that Parkinson's is caused by the decline in the brain's production of the chemical dopamine, the Basal Ganglia located in the middle of the brain is where many of the cells are which produces dopamine. Parkinsons is a very slow development of very telling symptoms and it typically takes a lot of years before these issues become disabling, the average age of dx is actually over 65, early onset Parkinson's is actually uncommon and usually much slower in younger people.

There are still no specific tests to confirm Parkinson's, dx is clinical so based on the combination of symptoms and their behavior patters eg at rest tremor, Bradykinesia (slowness), Dystonia,  pill rolling tremor, soft speech, freezing, limb rigidity etc and also ruling out all the alternative causes including medications, psychological, other movement disorders etc etc.

Over the years we've probably had some people dx with Parkinson's or Parkinsonism because of another medical conditions but i can't think of anyone still here or anyone dx'ed with MS who's actually mentioned having a family history of Parkinson's sorry...

What's got you thinking about Parkinson's?

Hope that helps....JJ
Avatar universal
Thank you for your comment.Iam thinking about that because my
Avatar universal
Thank you friend for your comment.Iam thinking about that because my mother suffers from Parkinson's and has become in the last stage of the disease, although the symptoms began only seven years ago.
1 Comments
Sorry to hear about your Mum, unfortunately with Parkinson's it's not uncommon to skip a few stages, its unpredictable on how long they'll be in each stage but if you mum is at stage 5 needing constant one-on-one nursing care in such a short time, does that mean no treatment has worked and she's not a candidate for deep brain stimulation (or DBS) or surgery?

In regards to MS, i couldn't find an association with Parkinson's but a lot of movement disorder conditions have similarities and if your still undx and concerned, it might be helpful for you to see a neurologist who specialises in movement disorders and or a clinical geneticist...

Hope that helps....JJ

Avatar universal

Your professional responses always helpful to me and I appreciate it. Yes, unfortunately my mom is not a good candidate for DBS.

To return to the MS, I have many symptoms that are similar to MS, so I'm afraid.

The MRI report without contrast says:

Findings: There are small T2W/FLAIR hyper intensities foci changes in both hemispheres located mainly in the white matter in juxtacortical region. The largest one measures 4 mm and seen in the left parietal lob No one of these lesions shows restriction on diffusion. These finding are most likely compatible with chronic ischemic changes.

Conclusion:  Some hyperintensities T2W/FLAIR changes in both hemispheres. These Lesions have aspecific significant (gliosis) but follow up and neurologist consultation are advised to exclude demyelinating disease. Right maxillary sinus retention cyst.

No cervical Lesions.

EMG is normal.

The neurologist said that there is no MS, and my symptoms are because of stress.

Iam afraid because according to the McDonald criteria, juxtacortical lesions are specific to MS. And I can’t believe that stress can cause all my symptoms.

I got another consultation and it was similar with the first one.

What makes me more afraid that many of the patients in this forum have been diagnosed with the disease after several years although the first diagnosis was not Ms.

What do you think??
Thank you for your help
1 Comments
Juxtacortical lesions are not specific to MS. If they were, diagnosis would be a lot more straightforward for many people. While radiologists do not diagnose, the part of the report that stands out the most to me is "These finding are most likely compatible with chronic ischemic changes."

For many people, the lesions that are imaged on brain MRIs have their roots in circulatory issues such as increased bloodpressure. That's what is meant by "ischemic changes".

But yes, stress can cause many actual physical symptoms. It is not a 'brush off'. Following up on possible non-organic causation is a doctor doing their due diligence. It's professional to exclude the most likely/most common suspects then working their way towards the least likely instead of the other way around.

It is understandably frustrating when faced with protracted diagnostic journeys and conditions with perpetual 'grey areas', but this is the state of medical knowledge at the present.
Avatar universal
Thank you very much for the explanation.

But when these lesions are present, and the symptoms are very similar to MS, so why he didn't consider that as a suspected MS.

I have also a Neurogenic bladder and the doctor did not care of it.
1 Comments
You haven't mentioned the results of an in-office neurological exam. These often tell neurologists a lot about a patient. For example, if I was otherwise in perfect condition and ran a marathon, a professional would still know something was amiss by simply running a car key up the bottom of my foot. My bilateral Babinski response is objective evidence of a neurological abnormality. This is just an example, but perhaps it sheds light on the multitude of things a neurologist considers when developing a list of likely suspects for a patient's issues.

Also, lesions can appear on MRI images for a variety of reasons, some of which are completely benign. Perhaps the neurologists agrees with the radiologist that yours are most likely the result of ishemic changes. In your shoes, I would ask him precisely what you put here, "Have you taken MS off the table? If so, why?" A good doctor should have no issue clarifying this.
987762 tn?1331027953
COMMUNITY LEADER
You've got more than enough reason to be 'stressed' and mental health can mimic neurological 'symptoms', so M/H 'could be' a legitimate medical causation but keep in mind that whilst symptoms can seem the same or similar, mental health and neurologically caused symptoms have specific characteristic features on clinical examination and understanding why both neurologist believe your symptoms are mental health would probably be very helpful to you....do you know what, if any abnormal clinical signs were found during your neurological assessment?


Information: Juxtacortical brain lesions
"The term juxtacortical is most commonly encountered in the brain in the context of multiple sclerosis, and is often poorly understood and misused. It is particularly important in the context of McDonald criteria, although oddly enough the term is not defined in either the original 2001 paper or the 2010 revision 1,2. Perhaps partly due to this, it is a term often misunderstood and thought to mean merely "sort of near the cortex". This is not the case, but rather it refers to lesions which abut the cortex 3, and thus involve the subcortical u-fibres. Another term which is perhaps more easily understood is leukocortical (i.e. involving both cortex and juxtacortical white matter). "
http://radiopaedia.org/articles/juxtacortical

I agree with what imm's pointed out and just wanted to add, that when ever a mental health causation has been placed on someones potential causation list, I always advice they get their mental health appropriately assessed by a psychiatrist or psychologist, as it's always in your best interest to get it confirmed or proven to not be mental health related, either outcome could be very helpful in the long run....

Hope that helps.......JJ
Avatar universal

Thank you my friends for helping and clarifying some issues.

I will go to  a brain & cervical MRI next month to make sure that there is no dissemination in time.
Avatar universal

last question. Some studies say that high stress and tension for a long period may cause MS, is this true??
5 Comments
No, that's not true. It's not yet known what causes MS, though it is likely an as yet undetermined combination of a genetic predisposition and environmental factors (e.g. previous viruses and level of vitamin D exposure during formative years).

It has been observed that high levels of stress can cause people who already have MS to perceive increased symptoms or longer-lasting relapses. Perhaps that's what was meant by the things you read.
I've not personally heard that before about stress, there are many things stress is associated with eg migraines, cancer, ulcers, gastric reflux, mental health issues, bowel issues, cardiovascular disease etc etc  but so far with MS they don't definitively know what triggers some peoples immune system to go haywire and attack the myeline sheath like it does, it's highly unlikely stress would be 'the' answer though.

Think about it, stress apart from being a common generic word which means totally different things to people, reactions to stress are individualistic eg a room full of 3-4yr old autistic children is understandably a stressful occupation but for the majority that work with disabled children their occupation whilst stressful is also highly rewarding and enriches their lives.

There are billion's' of people world wide that experience occupational related stress, financial related stress, mental health related stress, survival related stress etc etc in their day to day lives but there isn't the billions of MSers to corroborate stress as the trigger for MS.....chronic stress can negatively affect elements of the immune system and negatively affect health but statistically MS would be one of the less likely out comes, even if prolonged stress could be a trigger the immune system responses.

To me stress just doesn't add up or make sense as a likely cause....

Cheers....JJ

Hi Friends JJ and imm
Because I appreciate your comments and recommendations,  please advise me.
I went to my neurologist on Thursday and i told him that the symptoms are still going on and I do not know what to do.

He told me that my clinical examination is normal and this is a basic which he depend on, therefore, any symptoms that Iam feeling become unreliable” he siad. He told me also that the features of the lesions that appeared in the MRI are not In the context of of MS lesion ie the MS lesions features is different.
I told him that the ALTRASOUND report shows that i have a Cone shaped bladder ie Neurological bladder and he didn’t care.
I asked him: if my symptoms (numbness and weakness of the legs & hands, eyes & urine problems, and ...., are actually similar to MS symptoms?  He said: yes, but you don’t have MS and you don’t need to be followed with another MRI.
What do you think?
It does sound as though MS is very low on the list of what you may be dealing with. "Unreliable" is probably just an inelegant way of them saying "subjective" - symptoms that are self-reported but don't show up in testing. This doesn't mean they're not experienced by the patient, but that they are not consistent with something like MS or impossible to prove. What they're after are "signs" - things that show up in clinical tests. Even though you likely don't have MS, a doctor should be open to discussing treatment options for your symptoms.
Thank you imm

The doctor give me the option to take Lyrica and anti depression medicine or to mange my stress without it.
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