Re: incorrect diagnosis of parkinsons?

[Robert Fink <rafink@xxxxxxxxxxxxx>]

You wrote:

>
>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
>
>

Warren:  He needs an imaging study (CT or MRI scan).  He may have a
subdural hematoma or some other surgically treatable condition.  Please
keep me posted.

Best,

Bob

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Robert A. Fink, M. D., F.A.C.S.   Phone: 510-849-2555
Neurological Surgery              FAX:  510-849-2557
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