Thursday, June 16, 2022
Thursday, June 16, 2022
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What Diseases Are Similar To Parkinson’s

Environmental Factors And Exposures

What are the causes of Parkinson’s disease? Are there disorders that have similar symptoms?

Exposure to pesticides and a history of head injury have each been linked with PD, but the risks are modest. Never having smoked cigarettes, and never drinking caffeinated beverages, are also associated with small increases in risk of developing PD.

Low concentrations of urate in the blood is associated with an increased risk of PD.

Drug-induced parkinsonism

Different medical drugs have been implicated in cases of parkinsonism. Drug-induced parkinsonism is normally reversible by stopping the offending agent. Drugs include:

Medications And Parkinson’s Symptoms

Taking certain medicationsspecifically ones that block the action of dopaminecould cause Parkinson’s disease symptoms. It’s a condition called drug-induced parkinsonism, and while it isn’t Parkinson’s disease itself, it can look and feel a lot like it.

Here are some of the drugs can cause Parkinson’s disease symptoms:

  • Antipsychotics
  • Anti-nausea medications
  • Drugs that treat hyperkinetic movement disorders

Keep in mind that even though these medications could cause symptoms similar to Parkinson’s, they don’t cause the disease itself. And most of the time, the symptoms go away within hours or days once you stop taking that drug, per the Parkinson’s Disease Society.

In some cases, the Parkinson’s symptoms don’t go away after a person stops taking the medication that led to them, and they’re eventually diagnosed with Parkinson’s disease.

Researchers don’t think that the medication was the cause of Parkinson’s in those cases, but that those individuals’ dopamine levels were already depleted, and the side effects of the drugs revealed their underlying Parkinson’s disease. Put another way, the medication was the “straw that broke the camel’s back,” according to the American Parkinson Disease Association.

Research on what causes Parkinson’s disease continues to grow. If you experience symptoms of Parkinson’s, such as a tremor, slowed movement, balance problems, or changes in your speech or writing, connect with a doctor to diagnose the condition.

What Is The Prognosis

The disease gets progressively worse, with people becoming severely disabled within three to five years of onset. Affected individuals are predisposed to serious complications such as pneumonia, choking, head injury, and fractures. The most common cause of death is pneumonia. With good attention to medical and nutritional needs, it is possible for individuals with PSP to live a decade or more after the first symptoms of the disease appear.

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How Is Psp Different From Parkinsons Disease

PSP is often misdiagnosed as Parkinsons disease, especially early in the disorder, as they share many symptoms, including stiffness, movement difficulties, clumsiness, bradykinesia , and rigidity of muscles. The onset of both diseases is in late middle age. However, PSP progresses more rapidly than Parkinsons disease.

  • People with PSP usually stand exceptionally straight or occasionally tilt their heads backward . This is termed axial rigidity. Those with Parkinsons disease usually bend forward.
  • Problems with speech and swallowing are much more common and severe in PSP than in Parkinsons disease and tend to show up earlier in the disease.
  • Eye movements are abnormal in PSP but close to normal in Parkinsons disease.
  • Tremor is rare in PSP but very common in individuals with Parkinsons disease.

Although individuals with Parkinsons disease markedly benefit from the drug levodopa, people with PSP respond minimally and only briefly to this drug.

People with PSP show accumulation of the protein tau in affected brain cells, whereas people with Parkinsons disease show accumulation of a different protein called alpha-synuclein.

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Is There A Cure For Parkinsons

The Early Signs of Parkinsons Disease

Theres currently no cure for Parkinsons, a disease that is chronic and worsens over time. More than 50,000 new cases are reported in the United States each year. But there may be even more, since Parkinsons is often misdiagnosed.

Its reported that Parkinsons complications was the

Complications from Parkinsons can greatly reduce quality of life and prognosis. For example, individuals with Parkinsons can experience dangerous falls, as well as blood clots in the lungs and legs. These complications can be fatal.

Proper treatment improves your prognosis, and it increases life expectancy.

It may not be possible to slow the progression of Parkinsons, but you can work to overcome the obstacles and complications to have a better quality of life for as long as possible.

Parkinsons disease is not fatal. However, Parkinsons-related complications can shorten the lifespan of people diagnosed with the disease.

Having Parkinsons increases a persons risk for potentially life threatening complications, like experiencing:

  • falls

Parkinsons often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.

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How Is Parkinson Disease Treated

Parkinson disease cant be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.

A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.

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How Is Parkinsonism Diagnosed

You should be referred to a Parkinsons specialist for the diagnosis of any parkinsonism. They may wish to explore different things before giving you a diagnosis.

Your specialist will look at your medical history, ask you about your symptoms and do a medical examination.

Telling the difference between types of parkinsonism isnt always easy, for the following reasons:

  • The first symptoms of the different forms of parkinsonism are so similar.
  • In many cases, parkinsonism develops gradually. Symptoms that allow your doctor to make a specific diagnosis may only appear as your condition progresses.
  • Everyone with parkinsonism is different and has different symptoms.

Find out more: see our information on symptoms of Parkinsons, and diagnosing Parkinsons.

One of the most useful tests to find out what sort of parkinsonism you may have is to see how you respond to treatment.

If your specialist thinks you have idiopathic Parkinsons, theyll expect you to have a good response to Parkinsons drugs such as levodopa . A good response means that your symptoms will improve. Sometimes, it will only be clear that youve responded to medication when the drug is reduced or stopped, and your symptoms become more obvious again.

If you dont have any response to Parkinsons medication, your specialist will have to look again at your diagnosis.

Although not routinely available, your specialist may wish to carry out some of the tests below.

Current tests available include:

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Whats The Difference Between Progressive Supranuclear Palsy And Parkinsons

People with PSP generally progress more rapidly than people with Parkinsons. A person with Parkinsons tends to lean forward while a person with PSP tends to lean backward. Tremors are common in people with Parkinsons and rare in people with PSP. Speech and swallowing abnormalities are more severe and show up sooner in those living with PSP.

For more information on progressive supranuclear palsy, read this fact sheet and insights from the CurePSP organization website.

Which Test Can Be Done When The Diagnosis Is In Doubt

Parkinson’s Disease – Types and Prevalence

I request a small set of tests on almost all patients I diagnose with Parkinsons. These detect some mimics of Parkinsons disease.

Some doctors dont request all these tests. And for a good reason.

The diagnosis of Parkinsons mimics is primarily based on a careful history and examination.; Even in my practice, these tests change the diagnosis only in a minority of patients.

I like the additional confirmation provided by these tests. They also have other benefits. For example, they help me determine the proper dosages of medications like Amantadine.

Simple tests to detect Parkinsons Mimics
1. MRI-Brain with size measurements of brain parts called the midbrain and pons. I usually also request a unique picture called SWI, which shows iron inside the brain.

2. Blood tests:

  • Ceruloplasmin level & eye examination to look for a ring of copper
  • Ferritin level
  • HIV
  • VDRL
  • But when the diagnosis s really in doubt, there is another brain scan that can be done.

    A Trodat scan. Or even better an F-DOPA scan. Both these scans measure dopamine activity inside the brain.

    You can read more about Trodat & F-DOPA scans by clicking here.

    These scans are not perfect. Let me tell you why very quickly:

    In Parkinsons disease, dopamine activity inside the brain is deficient. This deficiency produces an abnormal scan. If the Trodat/F-DOPA scan is normal, it is unlikely that you have Parkinsons disease.

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    How Do Treatments Differ

    MS treatments can ease your symptoms during an attack or slow down the diseaseâs effects on your body.

    Steroids like prednisone calm the inflammation that damages your nerves.

    Plasma exchange is another therapy if steroids donât work. Your doctor will use a machine to remove the plasma portion of your blood. The plasma gets mixed with a protein solution and put back into your body.

    Some people with both diseases who take anti-inflammatory medicines like steroids see their Parkinsonâs symptoms get better.

    Disease-modifying treatments slow down MS nerve damage and disability. They include:

    National Institute for Neurological Disorders and Stroke: âTremor Fact Sheet.â

    Neurology: âParkinsonâs Disease in Multiple Sclerosis A Population-Based, Nationwide Study in Denmark .â

    Mayo Clinic: âMultiple Sclerosis: Overview,â âMultiple Sclerosis: Symptoms and Causes,â âMultiple Sclerosis: Treatment,â âParkinsonâs Disease: Causes,â âParkinsonâs Disease: Definition,â âParkinsonâs Disease: Risk Factors,â âParkinsonâs Disease: Symptoms.â

    Christopher Reeve Foundation: âHow the spinal cord works.â

    National Association for Continence: âParkinsonâs Disease.â

    National Multiple Sclerosis Society: âMS Symptoms,â âWho Gets MS? .â

    National Parkinson Foundation: âNon-Motor Symptoms.â

    Multiple Sclerosis Trust: âLhermitteâs sign.â

    Johns Hopkins Medicine: âPlasmapheresis.â

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    Living With Parkinson Disease

    These measures can help you live well with Parkinson disease:

    • An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
    • High protein meals can benefit your brain chemistry
    • Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
    • If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.

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    How Is Parkinson Disease Diagnosed

    Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinsons disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.

    What Are The Causes

    Infarct at ACA MCA watershed area, watershed infarcts

    The cause of Parkinson’s 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 .

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    Whats The Difference Between Drug

    Parkinsons is a progressive disorder, which will become worse over time, while DIP does not. In DIP, Parkinson-like symptoms can begin within four days to one month of starting the medication. However, all the symptoms could completely subside once the effecting medication is stopped, though it may take up to 18 months for all the symptoms to subside.

    For more information on drug-induced parkinsonism, read this journal article and/or information sheet.

    Whats The Difference Between Multiple System Atrophy And Parkinsons

    Parkinsons and MSA both affect the movement control system and the involuntary autonomic control system and early symptoms can make a differential diagnosis a challenge. MSA, however, tends to progress faster than Parkinsons; balance problems and a stooped posture happen earlier and get worse more quickly with MSA; and autonomic functions such as blood pressure, heart rate, breathing, sweating, bladder function, and sexual problems are more severe in people with MSA.

    For more information on multiple symptom atrophy, read this fact sheet.

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    How Is A Diagnosis Made

    Because other conditions and medications mimic the symptoms of PD, getting an accurate diagnosis from a physician is important. No single test can confirm a diagnosis of PD, because the symptoms vary from person to person. A thorough history and physical exam should be enough for a diagnosis to be made. Other conditions that have Parkinsons-like symptoms include Parkinsons plus, essential tremor, progressive supranuclear palsy, multi-system atrophy, dystonia, and normal pressure hydrocephalus.

    What Are The Symptoms Of Parkinson Disease

    Parkinson’s Disease and Depression: Symptoms and Treatments

    Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:

    • Tremors that affect the face and jaw, legs, arms, and hands
    • Slow, stiff walking

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    Gene Activity That May Underlie Parkinsons Revealed In New Analysis

    Studies on twins and families have suggested that susceptibility to;Parkinsons disease has a substantial genetic component. Now, an analysis of gene activity in different brain tissues has identified gene candidates that may be directly involved in causing the neurodegenerative disorder.

    The study, A transcriptome-wide association study identifies susceptibility genes for Parkinsons disease, was published in the journal NPJ Parkinsons Disease.

    One method to identify genetic risk factors is a genome-wide association study or GWAS, which compares genomic data from people with and without Parkinsons to find significant differences that may be linked to the disease. The genome is the entire set of genetic instructions present in a cell.

    However, many of the GWAS signals are often found in genomic regions outside genes, or the segments of DNA that carry instructions for proteins; thus, few have been implicated in specific biological mechanisms.

    Although recent GWAS has seen great strides in identifying risk associated with , the functional significance of these associations remains elusive, the researchers wrote.

    Using TWAS gene activity data from 13 different brain tissue samples, the researchers sought to identify gene candidates that may directly be involved in susceptibility to Parkinsons.

    Tobacco use disorder, cholesterol, and bone mineral density, also have been reported to be associated with , the researchers wrote.

    DISCLAIMER

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    Symptoms Of Parkinsons Disease

    Parkinson’s disease has four main symptoms:

    • Tremor in hands, arms, legs, jaw, or head
    • Stiffness of the limbs and trunk
    • Slowness of movement
    • Impaired balance and coordination, sometimes leading to falls

    Other symptoms may include depression and other emotional changes; difficulty swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.

    Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.

    Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.

    People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.

    The Right Diagnosis Can Save Time

    Blood test may help differentiate Parkinson

    Because the symptoms of Parkinsons vary and often overlap other conditions, it is misdiagnosed up to 30% of the time, Dr. Fernandez says. Misdiagnosis is even more common in the early stages.

    Patients;who dont know where to turn may make appointments with a rheumatologist, or an orthopaedic or heart specialist, and undergo MRIs, EMGs and other expensive tests.

    But only a neurologist can distinguish Parkinsons from essential tremor, drug-induced Parkinsons and Parkinsons plus syndromes, he says.

    If patients come to us with typical signs of Parkinsons, we dont need to order expensive tests, he says.

    Instead, neurologists base their diagnosis on a detailed patient exam and medical history, along with other information from the patient, family members or caregivers.

    Thats all stirred into the pot, he says. Sometimes we can diagnose Parkinsons with one visit. Other times, several follow-up visits are necessary.

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    Multiple System Atrophy Formerly Called Shy

    As predicted by the name of this parkinsonism, multiple system atrophy affects multiple systems of the body. It affects both the motor skills movement system and the involuntary system of the body. Though the symptoms can often be treated with medications, there is no cure. In addition, there are no drugs that are able to slow the progress of MSA.

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