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How Do You Diagnose Parkinson’s

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Do You Qualify For A Paraquat Lawsuit

Diagnosing Parkinsons Disease Video

Paraquat is manufactured by Syngenta, Growmark, and the Chevron Chemical Company. The first lawsuits were filed in 2017 by agricultural workers and farmers who got exposed to paraquat on the job and went on to develop Parkinsons disease.

Among other claims, the lawsuits state that:

  • Manufacturers knew the link between paraquat and Parkinsons disease for years,
  • The makers of paraquat failed to disclose or properly warn users about the risks, and
  • The workers wouldnt have used the product if theyd known about the dangers.

The claims of the lawsuit are based on:

  • Strict products liability The manufacturers of paraquat created a defective product and failed to warn users about the dangers to their health.
  • Negligence The companies had a responsibility to protect paraquat users. They knew or should have realized the neurological risks through adequate testing and they failed to remedy the risks or warn users against them.
  • Public nuisance The creators of paraquat knew or should have known that it would cause harm to the public if used without the proper warnings.
  • Breach of implied warranty of merchantability Paraquat as a product is not actually fit to be used as instructed because of the health risks.

As the link between paraquat and Parkinsons becomes increasingly apparent and more cases come forth, hundreds of additional lawsuits could be filed in the next few years.

Diagnosis Of Parkinson’s Disease

To diagnose Parkinsons, doctors will use a combination of diagnostic tests, physical exams, and a review of family and health history. In general, two of the four main physical symptoms must be present over a period of time for a Parkinsons diagnosis to be given.

If your primary care doctor believes you might have early onset of Parkinsons, they will refer you to a specialist like a neurologist or a movement disorder specialist for further tests.

Tests To Rule Out Other Conditions

Blood tests can help rule out other possible causes of the symptoms, such as abnormal thyroid hormone levels or liver damage.

An MRI or CT scan can check for signs of a stroke or brain tumor, which may cause similar symptoms.

Hydrocephalus due to atrophy can occur with some types of dementia and would be visible with one of these imaging tests. If the person has neurologic symptoms but a normal scan result, Parkinsons disease may be present.

The doctor a lumbar puncture to rule out inflammation or a brain infection.

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Gait & Balance Abnormalities

Parkinsons Disease Exam

Patients with Parkinsons disease can develop an alteration of the postural reflexes that causes instability in gait and balance control. Such alterations usually develop later in the course of the illness and are a major cause of disability, especially because of the high risk for falls that derives.

Using the exam to pick up postural instability is of the utmost importance for the management of patients with PD, since it will trigger either a medication adjustment or a physical therapy intervention both aimed at falls prevention.

We have three tests for this part of the PD exam:

1) Standing up from a chair

2) Free walking

3) Provoked pull test maneuver for balance

Mri In Parkinson’s Testing

Parkinson

One of the more common tests done during a neurologic workup is an MRI scan and one may think that in the investigation of a disease that affects the brain such as Parkinsons, this imaging test would be a necessity. In the context of Parkinsons disease, however, an MRI is not particularly helpful. It looks at the structure of the brain which, for all intents and purposes, appears normal in this disease. An MRI may, however, be indicated when symptoms appear in younger people or if the clinical picture or the progression of symptoms is not typical for Parkinsons. In these situations, MRI can be used to rule out other disorders such as stroke, tumors, hydrocephalus , and Wilsons Disease .

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What Causes Parkinson’s Disease

Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.

People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.

Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.

What Types Of Damages Can You Get In A Paraquat Lawsuit

A paraquat lawsuit can help you recover damages to make up for the injuries youve suffered. Personal injury lawsuits can reward economic and non-economic damages. That includes:

  • Past and future medical bills based on the treatment you need
  • Lost income and wages as a result of being unable to work for any period of time
  • Pain and suffering and loss of consortium caused by your disability or condition
  • Funeral expenses if youve lost a loved one because of paraquat

A Parkinsons disease diagnosis comes with significant costs. A civil lawsuit is the best way to make you whole under the law as if you were never exposed to paraquat. While monetary compensation cannot undo your diagnosis or disease, it can help you get the treatment you need so that you can take care of your health and live your life to the fullest.

Corporations that put dangerous products onto the market need to be held responsible for the damage and injuries that they cause. In the case of intentional, reckless, or malicious behavior, a court may even award punitive damages, which are meant to punish bad actors and discourage others from following their example.

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Does Stress Cause Parkinsons Disease

Research suggests that stressful life events may increase the risk of Parkinsons disease. In addition, animal studies indicate that stress damages dopamine cells, resulting in more severe parkinsonian symptoms. In humans, acute stress can worsen motor symptoms, including bradykinesia, freezing, and tremor.

Talking To Your Parents

Diagnosing Parkinson’s Disease by Dr. Steve McGee (Stanford Skills Symposium)

Telling your parents may be difficult, especially if youre caring for them in some way and dont want to burden them. Some parents have reactions of guilt at not having protected their children from something like Parkinsons. Encourage them to focus on what you need now. Try to keep your routines with them as consistent as possible and be honest about where you are on your journey with Parkinsons. Even if youre helping them, you can still be open and honest about your own experience.

Listen to Tom Palizzi as he talks about how he shared his Parkinsons diagnosis with family.

Rich Wildau discusses the same thing in the video below.

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Is Parkinsons Disease Inherited

Scientists have discovered gene mutations that are associated with Parkinsons disease.

There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.

Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.

Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.

Obtaining A Parkinson’s Disease Diagnosis

During the exam, the neurologist will look for cardinal symptoms of the disease. Facial expressions and features will be assessed. The doctor will look for signs of tremor while the patient is at rest. The doctor may watch how easily the patient stands up from sitting in a chair. The doctor may also stand behind the patient and gently pull back on the patients shoulders and look for how easily the patient can regain balance. Good responsiveness to levodopa also helps support the diagnosis of PD. However, taking levodopa may exclude patients from clinical studies that need to recruit recently diagnosed patients who have not yet had treatment . Participation in a clinical trial should be discussed with the doctor.

PD can be challenging to accurately diagnose, particularly in early stages of the disease, which is why a neurologist trained in movement disorders is critical. Approximately 5-10% of patients with PD are misdiagnosed, as many of the symptoms of PD are similar to other diseases. If the patient thinks that he or she has been misdiagnosed, a second opinion may help.1,2

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How Is Parkinsons Diagnosed

Doctors use your medical history and physical examination to diagnose Parkinson’s disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.

Researchers believe that in most people, Parkinson’s is caused by a combination of environmental and genetic factors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.

Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.

Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.

Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.

The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.

What Is A Datscan

Diagnosis of Parkinsons Disease

A DaTscan is an imaging drug, also called Ioflupane I 123 or phenyltropane, that acts as a radioactive tracer for dopamine transporters within the brain. This drug was approved by the FDA in 2011. It may help distinguish the diagnosis of essential tremor from Parkinson’s syndromes, like Parkinsons disease or Parkinsons disease dementia.

The drug is administered during the SPECT scan. This scanning technique gathers images of a particular area in the brain called the striatum, a cluster of neurons in the subcortical basal ganglia of the forebrain. The striatum helps facilitate the transportation of dopamine.

DaTscan is injected into the patients bloodstream and eventually circulates to the brain. The tracer attaches itself to a molecule found on dopamine neurons in the striatum called the dopamine transporter . The patient then undergoes a SPECT scan which will produce an image of the dopaminergic neuron terminals that remain available in the striatum.

In patients with a diagnosis of Parkinsons disease, or parkinsonism , this area of the brain will show dark. This indicates the loss of dopamine-containing nerve cells within the brain, a hallmark of the disease.

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Parkinsons Disease Is A Progressive Disorder

Parkinsons Disease is a slowly progressive neurodegenerative disorder that primarily affects movement and, in some cases, cognition. Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinsons Research, patients usually begin developing Parkinsons symptoms around age 60. Many people with PD live between 10 and 20 years after being diagnosed. However, a patients age and general health status factor into the accuracy of this estimate.

While there is no cure for Parkinsons disease, many patients are only mildly affected and need no treatment for several years after their initial diagnosis. However, PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. This progression occurs more quickly in some people than in others.

Pharmaceutical and surgical interventions can help manage some of the symptoms, like bradykinesia , rigidity or tremor , but not much can be done to slow the overall progression of the disease. Over time, shaking, which affects most PD patients, may begin to interfere with daily activities and ones quality of life.

Children Seven And Under

Begin by mentioning symptoms they may have already noticed. You might ask, Have you noticed that my hand is sometimes shaky, or that Ive been walking slower? We talked to the doctor, and it turns out that I have something called Parkinsons.

Give them the basic facts. Let them share what they have noticed, talk about things that might change, and stress that your medication is helping you feel better. Be clear and consistent in what you say and dont let the conversation go on too long. Remember, children pick up on a lot and will often mirror your demeanor. Maintain a positive attitude and make it okay for them to go on as before.

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Want More Practical Articles Like This

Much more can be found in our latest edition of Davis Phinney Foundations Every Victory CountsĀ® manual. Its packed with up-to-date information about everything Parkinsons, plus an expanded worksheets and resources section to help you put what youve learned into action. Request your copy of the Every Victory Counts manual by clicking the button below.

Passive Manipulation Of Limbs

How to Live Well with Parkinson’s for the Newly Diagnosed

To test for the presence of rigidity, we need to passively manipulate the limbs of the patient. However, If the disease is in its early stage or the symptoms are well controlled with medications, we may not be able to see rigidity. We will need to use some activation maneuvers, that basically consist in performing repetitive movements with the limb contralateral to the one that is being tested.

Also, there are two types of rigidity:

– Lead-pipe rigidity: where the tone is uniformly and smoothly increased throughout the entire range of movement

– Cogwheel rigidity: where a tremor is superimposed on the hypertonia, making the movement irregular due to intermittent increase and reduction of tone

Upper Extremity Testing

For the upper extremity the most sensitive joint where to check for rigidity is the wrist. To uncover rigidity, passively rotate the wrist and feel for a resistance to the movement. It is very important that the arm of the patient is fully relaxed when rotating the wrist. To do this, place your proximal hand under the patients forearm, while your distal hand grabs and rotates the wrist of the patient. When rigidity is present, the range of motion will be preserved but you will feel a resistance in performing the movement.

Wrist rotation with activation maneuver.

It is also possible to test for rigidity in the elbow by passively flexing and extending the forearm.

Elbow flexion-extension with activation maneuver.

Lower Extremity Testing

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What Are The Ways To Prevent Parkinsons Disease In A Patient

According to the research done so far, doctors and scientists believe that Parkinsons disease is triggered through a combination of genetic factors and exposure to factors like trauma and certain kinds of toxins and illness. Thus, the Parkinsons disease cannot be prevented as of now since proper etiology is yet to be discovered.

Testing For Parkinsons Disease

There is no lab or imaging test that is recommended or definitive for Parkinsons disease. However, in 2011, the U.S. Food and Drug Administration approved an imaging scan called the DaTscan. This technique allows doctors to see detailed pictures of the brains dopamine system.

A DaTscan involves an injection of a small amount of a radioactive drug and a machine called a single-photon emission computed tomography scanner, similar to an MRI.

The drug binds to dopamine transmitters in the brain, showing where in the brain dopaminergic neurons are.

The results of a DaTscan cant show that you have Parkinsons, but they can help your doctor confirm a diagnosis or rule out a Parkinsons mimic.

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What Is Parkinson’s Disease

Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.

The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.

Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.

For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.

What Is Parkinson’s Disease?

Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.

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