Conditions That May Be Mistaken For Parkinsons Disease
There are a few conditions that may be confused with Parkinsons disease. These conditions can cause similar symptoms, and because there is no definitive test that proves you have Parkinsons disease or any of these similar conditions. As you might imagine, this can make it challenging at times for doctors to figure out which condition you have. A few of the most common conditions that might look like Parkinsons are:
What Is Rem Behavior Disorder And How Is It Connected To Parkinson’s
A: REM behavior disorder is different than other sleep problems, like insomnia. People who have it may jerk or kick it’s as though they are acting out their dreams. In a similar pattern to anosmia, people with idiopathic REM sleep behavior disorder have at least a 50 percent chance of eventually developing Parkinson’s disease.
Theory Of Pd Progression: Braaks Hypothesis
The current theory is that the earliest signs of Parkinsons are found in the enteric nervous system, the medulla and the olfactory bulb, which controls sense of smell. Under this theory, Parkinsons only progresses to the substantia nigra and cortex over time.
This theory is increasingly borne out by evidence that non-motor symptoms, such as a loss of sense of smell , sleep disorders and constipation may precede the motor features of the disease by several years. For this reason, researchers are increasingly focused on these non-motor symptoms to detect PD as early as possible and to look for ways to stop its progression.
Page reviewed by Dr. Ryan Barmore, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
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How Can Parkinsons Affect My Driving
Driving is a complex task. It requires physical strength, mobility, good reflexes and reaction time, depth perception, good eyesight and hearing and the ability to multi-task and keep track of many visual and spatial inputs at once.
Some of the symptoms of Parkinsons can make executing all of those tasks a challenge. A few symptoms that are the most troublesome when it comes to driving include:
- Tremor in legs, arms and hands
- Compromised balance
- Freezing that can make it difficult to get moving again once youve been still
- Slower reaction time and diminished reflexes
- Side effects from taking medications such as sleepiness, blurred vision and confusion
- Mild to severe cognitive impairment
- Dementia
Many of the medications you may be taking can dramatically mitigate your symptoms however, its important to remain vigilant when considering how safe youre able to be on the road.
If youre still driving, here are a few actions you can take to optimize your safety and the safety of others:
- Reduce distractions such as talking, eating, listening to the radio or anything else that requires concentration
- Avoid night driving if your vision is worse in the dark
- Avoid driving during off times when your medication isnt as effective
- Use a GPS system and plan ahead of time if youll be driving in unfamiliar areas
- Avoid driving when youre tired
If you get to a point when youre starting to wonder if you should still be driving, there are several things you can do.
Tom Thought That Because Some Pink Tablets Relieved His Symptoms This Meant He Was Ok He Didn’t
I first suspected there was something wrong when I was travelling and I was writing a postcard to a friend of mine in, in Australia whose name is Anthony Diecopolis. And, and I got to the Anthony Diec and I couldnt finish the opolis. And its very strange my hand had sort of gone into a sort of spasm and it just wouldnt, wouldnt finish writing the, the, the word. And so thats a bit strange.
And so I went when, when I got I, I went to the doctor and said, What on earths going on? And I had since then Id also developed this slight tremor in my right hand. He said, Well its probably, Essential Tremor or trapped nerve or something like that. And anyway, then it got a bit worse and then I was, I was recommended to go to a neurologist. And the neurologist had a look at me and gave me some pills. And he said, Come back and tell me if these work.
This is about, about sort of, nine months after my, my not being able to finish the, the postcard. And, and he said, Take these pills. And the pills worked. Magically the tremors stopped and I thought this is wonderful. And so I went back to the neurologist and I said, Yes everythings fine now. The pills have, the pills have worked. And far from looking happy about this he looked rather, rather grave and he said, I think youd better go to another neurologist.
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Do You Die From Pd Dementia
People with Parkinsons-related dementia often want to know how the disease can impact their lifespan. While people with Parkinsons can expect a similar lifespan to the general population, studies show both Parkinsons disease dementia and Lewy body dementia can shorten lifespan, generally due to medical complications from the disease, rather than the disease itself.
What Makes Pd Hard To Predict
Parkinsonâs comes with two main buckets of possible symptoms. One affects your ability to move and leads to motor issues like tremors and rigid muscles. The other bucket has non-motor symptoms, like pain, loss of smell, and dementia.
You may not get all the symptoms. And you canât predict how bad theyâll be, or how fast theyâll get worse. One person may have slight tremors but severe dementia. Another might have major tremors but no issues with thinking or memory. And someone else may have severe symptoms all around.
On top of that, the drugs that treat Parkinsonâs work better for some people than others. All that adds up to a disease thatâs very hard to predict.
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Are There Medicines To Treat Pdd
Though there is no cure for PDD yet, there are medications that help manage the symptoms. These medications are called cholinesterase inhibitors, and they can help if a person with PDD is having memory problems. Some examples of these medicines are donepezil, rivastigmine and galantamine. Sleep problems may be managed by sleep medications such as melatonin.
Because people with PDD are usually very sensitive to medications, any new medication, even one that is not being used for the brain, needs to be reviewed with the persons provider to avoid potential contraindication.
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
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How Do You Get Parkinsons Disease
A patient gets Parkinsons disease due to degeneration or destruction of the nerve cells which produce dopamine. Absence of the neurotransmitter called dopamine makes it difficult for the brain to control and coordinate muscle movements which in turn produces symptoms of tremors. It must be remembered that Parkinsons disease is a progressive neurological disorder.
There are no particularly specific tests that confirm the presence of Parkinsons disease. Once the patience comes with the symptoms, the doctor usually takes the physical history of the patient. His way of walking and level of cognition is assessed. The doctor then may ask the patient to go for certain tests like-
Blood Test- The blood test is usually done in order to rule out any other condition responsible for the symptoms of motor instability. Such conditions may include lever damage or abnormal thyroid level.
MRI and CT Scans- The patient may be asked to go for a CT or MRI scans to diagnose the presence of brain tumor or stroke. The MRI or CT scan results with Parkinsons disease are usually normal.
PET Scan- PET scan may help in the detection of low levels of dopamine in the brain at times. PET scans are highly specialized imaging technique, which uses substances which are radioactive in nature to create three dimensional images of the substances in the body.
Normal Cognition Early In Pd Predicted Normal Life Expectancy
Parkinsons disease patients who had normal cognitive function at the start of a prospective, community-based study had a largely normal life expectancy, researchers reported.
But Parkinsons disease patients who had early freezing of gait, severe hyposmia, cognitive impairment, or subtle inflammation in their cerebrospinal fluid had a significantly shorter life span, reported David Backstrom, MD, of Umea University in Sweden, and colleagues in Neurology.
Action Points
- Patients with Parkinsons disease who have mild disease and normal cognition at onset have a mortality rate equivalent to that of the general population, according to a Swedish study of 182 patients with new-onset, idiopathic parkinsonism.
- Recognize that patients with incident parkinsonism have overall reduced survival, but that the survival is highly dependent on the type and characteristics of the parkinsonian disorder.
The prognosis of Parkinsons disease and parkinsonism is best studied by long-term follow-up of community-based incident cohorts, Backstrom told MedPage Today. Mortality among Parkinsons disease patients can be highly variable, and this study provides a better characterization of the neurobiological factors that are associated with short survival in Parkinsons disease.
Disclosures
Editorialists reported relationships with CurePSP, Biogen, AbbVie, American Parkinsons Disease Association, the Rutgers Foundation, and UBS.
Primary Source
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Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- medication
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
What Is Essential Tremor And How Is It Different To A Parkinsons Tremor
A tremor is a rhythmical, involuntary movement that affects a part of the body, such as the hand.
Essential tremor is the most common type of tremor. Its most noticeable when your hands are doing something and it usually affects both the right and left sides of the body equally. Essential tremors often lessen when your body is resting.
Unlike an essential tremor, a Parkinsons tremor is most obvious when the affected body part is resting and tends to be less noticeable with movement. It usually starts on one side of the body and may progress to the other side as Parkinsons develops.
The time it takes to get a diagnosis can vary from person to person. Some people may receive a diagnosis of Parkinsons quite quickly, but for others it may be a long process. This can be due to a number of things, including your medical history, your age and what symptoms you have.
Your specialist may wish to rule out other causes of your symptoms first and see how you respond to treatment. This may take some time, and, as already mentioned, there is currently no definitive test for Parkinsons.
How you respond to treatment may help your specialist make a diagnosis. Keeping a diary or record of your symptoms will give the specialist more information to guide their decision.
Because the symptoms of Parkinsons are sometimes similar to other forms of parkinsonism, people can sometimes be misdiagnosed.
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Who Gets Early Onset Parkinsons Disease
About 10%-20% of those diagnosed with Parkinsons disease are under age 50, and about half of those are diagnosed before age 40. Approximately 60,000 new cases of Parkinsons are diagnosed each year in the United States, meaning somewhere around 6,000 12,000 are young onset patients.
Is it genetic or hereditary?
The cause of Parkinsons disease is not yet known. However, Parkinsons disease has appeared across several generations of some families, which could indicate that certain forms of the disease are hereditary or genetic. Many researchers think that Parkinsons disease may be caused by genetic factors combined with other external factors. The field of genetics is playing an ever greater role in Parkinsons disease research, and scientists are continually working towards determining the cause or causes of PD.
Key Programs And Resources
The Parkinsons Disease Biomarkers Programs , a major NINDS initiative, is aimed at discovering ways to identify individuals at risk for developing PD and Lewy Body Dementia and to track the progression of the disease. It funds research and collects human biological samples and clinical data to identify biomarkers that will speed the development of novel therapeutics for PD. Goals are improving clinical trials and earlier diagnosis and treatment. Projects are actively recruiting volunteers at sites across the U.S. NINDS also collaborates with the Michael J. Fox Foundation for Parkinsons Research on BioFIND, a project collecting biological samples and clinical data from healthy volunteers and those with PD. For more information about the PDBP and how you can get involved, please visit the PDBP website.
The NINDS Morris K. Udall Centers of Excellence for Parkinsons Disease Research program supports research centers across the country that work collaboratively to study PD disease mechanisms, the genetic contributions to PD, and potential therapeutic targets and treatment strategies.
The NINDS Intramural Research Program conducts clinical studies to better understand PD mechanisms and develop novel and improve treatments.
The NINDS Biospecimens Repositories store and distribute DNA, cells, blood samples, cerebrospinal fluid, and autopsy tissue to PD researchers around the world.
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You May Notice These Vocal Changes Too
Besides speaking quietly, individuals with Parkinson’s often experience a range of other vocal changes. These may include speaking with a hoarse voice, speaking in monotone, a vocal tremor, changes in the rate of speech, decreased articulation or slurring, and more.
Experts say that this particular symptom often presents as the first sign of Parkinson’s. “Emerging evidence suggests voice dysfunction is the earliest sign of motor impairment in Parkinson’s disease . The complexity and fine motor control involved in vocalization may result in dysfunction here before the limbs,” says a study published in the Journal of Clinical Neuroscience. This often contributes to the symptom being overlooked until other symptoms emerge.
When Does Parkinsons Start
Many people live with Parkinsons for years before being officially diagnosed. Early symptoms are called pre-motor symptoms and effects like constipation, depression and loss of smell can begin anywhere from a few months to multiple decades before a diagnosis or more visible motor symptoms like tremor appear. Looking back after diagnosis, some people can pinpoint the onset of their Parkinsons or recognize seemingly disconnected symptoms that in hindsight were really the start of what they can now identify as Parkinsons symptoms.
For younger people with Parkinsons or those without the more classic symptoms of tremor, rigidity and slow movement, the diagnosis can be more difficult and take longer to confirm.
Parkinsons is complex, multifaceted and not to be faced alone. Putting together a strong care team among your family and community, friends and mentors in the Parkinsons community and various healthcare professionals will help you best manage symptoms and enjoy the best possible quality of life.
A care team can range from your family members to your acupuncturist, and include just about everyone in between! Since Parkinsons impacts each person so differently, your care team will be unique to you and it will change and evolve as your symptoms do the same. Healthcare providers, complementary therapy specialists and even emotional well-being professionals should all be considered as you evaluate who best fits on your personal care team.
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What Are The Secondary Symptoms Of Parkinsons Disease
The primary symptoms of the Parkinsons disease have to be obviously movement related and lose of muscles control. Since it is a neurodegenerative disease, continued damage to brain leads to secondary symptoms which vary in severity and people-
- Feelings of insecurity, anxiety and stress.
- Loss of memory, confusion and dementia.
- Constipation.
- Erectile dysfunction or ED in men.
- Speech problems.
What Tests Might I Have
Your doctor may want to start by testing your blood or doing a brain scan to rule out other conditions.
People who have Parkinsonâs disease donât make enough of a brain chemical called dopamine, which helps you move. If those first tests donât show a reason for your symptoms, your doctor may ask you to try a medication called carbidopa-levodopa, which your brain can turn into dopamine. If your symptoms get much better after you start the drug, your doctor probably will tell you that you have Parkinsonâs disease.
If the medication doesnât work for you and thereâs no other explanation for your issues, your doctor might suggest an imaging test called a DaTscan. This uses a small amount of a radioactive drug and a special scanner, called a single photon emission computed tomography scanner, to see how much dopamine is in your brain. This test can’t tell you for sure that you have Parkinson’s disease, but it can give your doctor more information to work with.
It can take a long time for some people to get a diagnosis. You may need to see your neurologist regularly so they can keep an eye on your symptoms and eventually figure out whatâs behind them.
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