Re: No more tremors

["James F. Slattery" <jslat@xxxxxxxxx>]

> From: Gregory Danton <dantongr@xxxxxxxxxxxx>
> Subject: No more tremors
>
> ...I have heard of a few people
> losing all of their PD related symptoms after a hospital or doctor visit
> to treat other diseases. In other words they go to the doctor for high
> blood pressure and take high blood pressure drugs and apparently lose
> all of their PD symptoms. Has anyone else ever heard of anything like
> this happening?

There are over two dozen other disorders that mimic PD in one or more
symptoms, such as Pseudobulbar Palsy, a common disorder that occurs in
patients with disease of the blood vessels of the brain (Arteriosclerosis),
and Progressive Supranuclear Palsy, an uncommon disorder in which patients
develop paralysis of their eye movements, difficulty in speaking, rigidity,
and senility.  Neither of these disorders responds to Sinemet.

Then there is the so-called "idiopathic", or atypical PD, in which some or
all of the symptoms are peculiar to the sufferer.  This has been said to be
the type of PD suffered by, among others, Muhammad Ali.

In one respect, PD could be said to be "that assembly of symptoms which
responds to Sinemet"!  Or at least, to some form of L-dopa medication.

Perhaps for that reason, I have seen PD referred to more recently as
"dopamine deficiency syndrome", indicating a collection of symptoms caused
by insufficient dopamine production.  From my readings, however, I feel
more inclined to term "typical" PD, as "acetylcholine/dopamine imbalance",
since an over- or under-supply of either of these two messengers can cause
Parkinsonian symptoms.  (Thus the often-violent dyskinesia experienced
when, for example, a sudden release of Sinemet CR overlays an existing
release of standard Sinemet.)

All this, plus the idiosyncrasy reaction of individual sufferers to
medication regimens, makes PD a difficult diagnosis to confirm
unequivocally. Not to mention the fact that there is no way to measure, as
one writer put it, an individual patient's "initiative, determination,
spirit, or drive-all qualities which can transcend the patient's
disability."  :-)

So, to avoid making a long story even longer, let's just say that some
people are diagnosed with PD, where their symptomatology may more
accurately suggest, at the most, Parkinsonism (PD look-alikes), and that
further treatment for other disorders serendipitously "cures" their "PD".

No miraculous "silver bullet", I am sorry to say; at least not in the near
future.  :-(

Jim