incorrect diagnosis of parkinsons?

[Warren Whitney <wjw@xxxxxxxxxxxxxx>]

On January 17, Ann M Strozewski <cavin@xxxxxxxxxxxx> wrote describing
symptoms which are suspected to be perhaps not parkinson's because of
1- lack of apparent response to sinimet
2- a very rapid progression after not progressing much for 1.5 yrs.

This sounds very much like my father.  After not progressing much for
several years, the symptoms increased dramatically.  Also there is
not an obvious effect of sinemet.

The rapid progression of symptoms may have been precititated by a fall
(bumped his head).  He went from walking (preferably with a walker) to
bed ridden, in a couple of days.  He spent a week in the hospital, and then
had to go to a nursing home.  He is now in a wheelchair.

He also has severe dementia.

His neurologist, who we think is quite good, does not feel this is
unusual.  His comment is that after any period of immobility, such as
the time he spent in the hospital, it is extremely difficult to work
back to where he was.  His feeling is that even if he put forth supreme
effort to get back some mobility, he would soon end up back in the
wheelchair.  Besides, in his current mental state he does not seem
capable of embarking on a rehabilitation program and sticking with
it, noting progress, etc.

The neurologist sees nothing unusual and does not suspect any
other diagnosis.

In summary, he seems characterized by:

-little apparent response to sinemet
-severe dementia
-hallucinations
-no longer can walk
-unclear speech
-mild tremor
-very rapid progression in a short time

He is taking 3X sinemet CR.  He was taking 2X eldepryl, but we discontinued
based on comments from this list saying the eldepryl was bad for mental
confusion.  But discontinuing eldepryl apparently had no positive effect.

Any comments?  Thanks...

Warren Whitney
Ann Arbor, MI
email 705.3331@xxxxxxxxxxx or wjw@xxxxxxxxxxxxxx