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How To Be Diagnosed With Parkinson’s Disease

Can A Stroke Cause Parkinsons Disease

What Do People Who Have Been Newly Diagnosed With Parkinson’s Disease Need to Know?

A stroke can cause some symptoms of Parkinsons disease, but not Parkinsons disease itself. This condition is called Parkinsonism. Parkinsonism is associated with many of the same movement problems of Parkinsons disease, such as tremors and stiffness. However, it usually does not worsen over time as Parkinsons disease does. If a stroke causes brain damage in the area of the brain that is associated with Parkinsons disease, then Parkinsonism can occur.

What Is A Datscan

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.

Stiffness And Slow Movement

Parkinsons disease mainly affects adults older than 60. You may feel stiff and a little slow to get going in the morning at this stage of your life. This is a completely normal development in many healthy people. The difference with PD is that the stiffness and slowness it causes dont go away as you get up and start your day.

Stiffness of the limbs and slow movement appear early on with PD. These symptoms are caused by the impairment of the neurons that control movement. A person with PD will notice jerkier motions and move in a more uncoordinated pattern than before. Eventually, a person may develop the characteristic shuffling gait.

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The 5 Stages Of Parkinsons Disease

Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.

What Are The Symptoms

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Symptoms of PD vary from person to person, as does the rate of progression. A person who has Parkinsons may experience some of these more common hallmark symptoms:

  • Bradykinesia slowness of movement, impaired dexterity, decreased blinking, drooling, expressionless face.
  • Tremor at rest involuntary shaking that decreases with purposeful movement. Typically starts on one side of the body, usually the hand.
  • Rigidity stiffness caused by involuntary increase in muscle tone.
  • Postural instability sense of imbalance. Patients often compensate by lowering their center of gravity, which results in a stooped posture.

Other symptoms that may or may not occur:

Freezing or being stuck in place Shuffling gait or dragging of one foot Stooped posture Cognitive impairment

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In Summary Reduce Your Stress

The most important thing we can do for our long-term health, both physical and cognitive, is to reduce the stress in our bodies. All stress physical, emotional and chemical causes inflammation and long-term damage throughout the body.

Whether youre seeking Parkinsons prevention techniques or ways to alleviate symptoms, any of the above dietary and lifestyle practices can have long-term health benefits. Drinking green tea, eating organic, local vegetables, and regular aerobic exercise all significantly reduce the long-term cumulative damage done by stress.

Learn more about health services offered at Judson by !

What Are The Non

While Parkinsons disease is often associated with movement changes, there are a variety of non-motor symptoms, as well. Non-motor symptoms refer to the many other changes to a persons health and wellbeing that can happen from Parkinsons.

These symptoms can sometimes have an even greater impact on a persons life than tremor, rigidity, and slow movement, so its important to keep an eye out for them in someone with the disorder. Here are some of the non-motor symptoms of Parkinsons disease to look out for:

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Who Gets Parkinson’s Disease

About 1 million people in the United States have Parkinson’s disease, and both men and women can get it. Symptoms usually appear when someone is older than 50 and it becomes more common as people get older.

Many people wonder if you’re more likely to get Parkinson’s disease if you have a relative who has it. Although the role that heredity plays isn’t completely understood, we do know that if a close relative like a parent, brother, or sister has Parkinson’s, there is a greater chance of developing the disease. But Parkinson’s disease is not contagious. You can’t get it by simply being around someone who has it.

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Sensitivity Specificity And Predictive Value Of A Previous Diagnosis Of Parkinson’s Disease

Of 126 patients with a pre-existing clinical diagnosis of probable and possible Parkinson’s disease in the overall sample , 111 were confirmed as having Parkinson’s disease, resulting in a sensitivity of 88.1% similarly, it was confirmed that 54 of 74 patients did not have Parkinson’s disease, resulting in a specificity of 73.0% . The positive and negative predictive values of a previous clinical diagnosis of Parkinson’s disease were 84.7% and 78.3% . In other words, in 85% of patients with a previous diagnosis of Parkinson’s disease this diagnosis was confirmed, and 78% of patients with a diagnosis other than Parkinson’s disease did not have the disease .

When this was broken down by a specialist or other doctor diagnosis, the diagnostic validity was as follows. Neurologists and geriatricians had a sensitivity and specificity of 93.5% and 64.5% , respectively, compared with 73.5% and 79.1% for non-specialists. The positive predictive values were greater for specialists than for other doctors , but the negative predictive values were equivalent v non-specialist 79.1% ).

What Are The Symptoms Of Parkinson’s Disease

The symptoms of Parkinson’s disease include tremors or trembling difficulty maintaining balance and coordination trouble standing or walking stiffness and general slowness.

Over time, a person with Parkinson’s may have trouble smiling, talking, or swallowing. Their faces may appear flat and without expression, but people with Parkinson’s continue to have feelings even though their faces don’t always show it. Sometimes people with the disease can have trouble with thinking and remembering too.

Because of problems with balance, some people with Parkinson’s fall down a lot, which can result in broken bones. Some people with Parkinson’s may also feel sad or depressed and lose interest in the things they used to do.

The symptoms of Parkinson’s disease appear gradually and get worse over time. But because Parkinson’s disease usually develops slowly, most people who have it can live a long and relatively healthy life.

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What Are The Surgical Treatments For Parkinsons Disease

Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.

Recently Fred Has Found His Eyes Are Closed Involuntarily Most Of The Time Though If He Makes An

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You dont think, Oh, it would be nice to have my eyes closed now?

The mask that is the expressionless face, typical of many people with Parkinsons, probably distresses the people who have to live with it more than it embarrasses the person who has it. It tends to be the position the face falls into when not actively doing something else. Lack of facial expression can be hard for the family.

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Patients With A Previous Diagnosis Other Than Parkinson’s Disease

Among all patients seen, two were referred for diagnostic purposes without a previous diagnosis, and 69 of 202 patients had a previous diagnosis other than Parkinson’s disease . Among these, 56 patients had been given a diagnosis of non-parkinsonian tremor, two of vascular parkinsonism, one of atypical parkinsonism, and 10 had been prescribed an antiparkinsonian drug for parkinsonian features without a specific diagnosis . Thirteen of the 69 patients with different diagnoses and the two patients referred for diagnostic purposes fulfilled strict clinical criteria for Parkinson’s disease . In two additional patients who had a previous diagnosis of non-parkinsonian tremor, a diagnosis of possible Parkinson’s disease was made . If only patients who had at some point in the past seen a specialist were considered, the diagnosis was changed to probable Parkinson’s disease in five and to possible Parkinson’s disease in one .

Sensitivity, specificity, and predictive values for the overall sample* and by type of clinician

Living With Parkinson’s Disease

As Parkinson’s develops, a person who has it may slow down and won’t be able to move or talk quickly. Sometimes, speech therapy and occupational therapy are needed. This may sound silly, but someone who has Parkinson’s disease may need to learn how to fall down safely.

If getting dressed is hard for a person with Parkinson’s, clothing with Velcro and elastic can be easier to use than buttons and zippers. The person also might need to have railings installed around the house to prevent falls.

If you know someone who has Parkinson’s disease, you can help by being a good friend.

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What Causes Parkinsons Disease

Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.

People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.

Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.

Shifting Abilities Role Reversals

What are the symptoms of Parkinson’s disease and how is it diagnosed?
  • People with PD often need more time to perform activities because of changes in hand coordination, muscle stiffness or slowness. Conflict may arise as it becomes necessary to reevaluate who is responsible for what tasks in the family and around the home.
  • Changing abilities and assuming new roles can cause frustration and emotional upheaval.
  • Stress makes PD symptoms worse.

What to do

  • Maintain open communication with your loved ones.
  • Prioritize daily tasks. Get outside help as needed for some tasks such as yard work, housecleaning or home maintenance.
  • Regular exercise can help manage stress.
  • Seek help from a counselor to resolve relationship conflicts.

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Early Signs Of Parkinson’s

Early physical signs include the common motor symptoms: tremor, muscle rigidity and slowness. They may also include the following:

  • Symptoms starting on one side of the body
  • Change in facial expression
  • Failure to swing one arm when walking
  • Stooped posture
  • Loss of sense of smell
  • Depression or anxiety

Some of these symptoms are quite common and by no means exclusive to Parkinsons, so if you have some of them, it does not mean you have Parkinsons.

The Importance Of Early Diagnosis

Early detection and diagnosis is important because the treatments for PD are more effective in the early stages of the disease. In addition, physical therapy and exercise, which greatly improve symptoms and delay progression of the disease, are much easier to perform in the early stages.

Current diagnosis is made through the presence of motor symptoms however, researchers have found that by the time motor symptoms occur, over 60% of all dopamine neurons in the basal ganglia of the brain have been damaged. Non-motor symptoms become apparent in people with PD long before motor symptoms, including sleep disturbances and loss of the sense of smell.3

Active areas of research include looking for markers in the blood, urine, or cerebral spinal fluid that reliably detect PD, called biomarkers. In addition, brain imaging tests that have high sensitivity for detecting PD are also being actively researched.4

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Conditions Misdiagnosed As Parkinson’s Disease

Parkinsons disease, especially in its early stages when symptoms are mild, is not an easy disease to diagnose. The non-specific, and easily overlooked nature of the signs of Parkinsons make it difficult to spot, and unlike many illnesses, there is no one laboratory test or radiological exam that will provide a definitive diagnosis of Parkinsons disease.

Patients exhibiting Parkinsons-like symptoms may undergo blood and urine tests, or CT or MRI scans to exclude other conditions, but none of these will provide a diagnosis of Parkinsons disease. The best way to test for Parkinsons disease is to conduct a systemic neurological examination that includes tests to gauge a patients reflexes, muscle strength, coordination, balance, gait, and overall movement. Even so, according to information presented on The Michael J. Fox Foundation for Parkinsons Research, up to 25 percent of Parkinsons disease diagnoses are incorrect.

So, why is there confusion about diagnosing Parkinsons disease? The simple answer is that symptoms of Parkinsons disease are not clear cut, and therefore, it is easy to mistake them for other conditions, or to classify them as parkinsonian when they are not.

Here is a brief overview of the top ten conditions mistaken for Parkinsons disease:

Beyond those top three, there are other conditions that are often confused with Parkinsons disease, including:

Obtaining A Parkinson’s Disease Diagnosis

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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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What Are The Causes

The cause of Parkinsons is largely unknown. Scientists are currently investigating the role that genetics, environmental factors, and the natural process of aging have on cell death and PD.

There are also secondary forms of PD that are caused by medications such as haloperidol , reserpine , and metoclopramide .

Support For People With Parkinsons Disease

Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.

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Definition Of Terms Used In The Analysis

Sensitivity: Proportion of patients with a final diagnosis of Parkinson’s disease who were previously diagnosed as having Parkinson’s disease: A/.

Specificity: Proportion of patients without a final diagnosis of Parkinson’s disease who were previously diagnosed as not having Parkinson’s disease: D/.

Positive predictive value: Proportion of patients with a previous diagnosis of Parkinson’s disease who received a final diagnosis of Parkinson’s disease: A/.

Negative predictive value: Proportion of patients with a previous diagnosis of not having Parkinson’s disease who received a final diagnosis of not having Parkinson’s disease: D/.

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