Is it really PD?

["J.R. Bruman" <jrbruman@xxxxxxxxxx>]

Dear listmembers, I got so many requests that I must cut it off at
this point- but for those who may still be interested it seems
worthwhile to post this much shortened version. I'll still answer
specific questions about references, etc. by e-mail if I can:

In an organ as complex as the brain, one can't expect each of its
many illnesses to be precisely defined and distinct from all the
others. Moreover, conditions having similar or related symptoms
may often be combined. Partly for those reasons, the job of
diagnosis is best left to the highly trained neurologist:

Primarily Motion Disorders:

Abbr.   Terminology          Relative           Suspicious
                             Frequency*         Features

PD    Parkinson's Disease         78%    tremor, rigidity, slowness;
                                         responds to dopaminergic drugs

ET    Essential Tremor            ??     tremor alone; responds to
                                         Inderal, Mysoline, alcohol

--    Parkinsonism Plus           12%    various forms of Multiple
                                         System Atrophy (MSA) below:

PSP   Progressive Supranuclear   7.5%    eye and eyelid control
      Palsy                              problems

SDS   Shy-Drager Syndrome        1.7%    orthostatic hypotension

OPCA  OlivoPontoCerebellar       < 1%    parkinsonism plus ataxia
      Atrophy

SND   StriatoNigral Degeneration < 1%    early-onset falling, dysarthria;
                                         may respond to levodopa at first

CBGD  CorticoBasal-Ganglionic    < 1%    parkinsonism plus apraxia
      Degeneration                       plus marked asymmetry

--    Secondary Parkinsonism       8%    toxin, trauma, stroke, tumor etc.

*These frequencies occurred in a sample of some 2000 patients a few years
ago. ET often occurs together with PD; when occurring alone it is often
misdiagnosed as PD, or may go untreated, so its frequency is unknown.

Other diseases which at onset may suggest PD or occur with PD:

MS   Multiple Sclerosis
ALS  Amyotrophic Lateral Sclerosis (Lou Gehrig Disease)
AD   Alzheimer's Disease
CJD  Creutzfeldt-Jakob Disease

Not a cheerful message, but I hope useful.


J. R. Bruman (818) 789-3694
3527 Cody Road
Sherman Oaks CA 91403