What Is The Prognosis And Life Expectancy For Parkinson’s Disease
The severity of Parkinson’s disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinson’s disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
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.
The Thyroid And Hypothyroidism
The thyroid is a butterfly-shaped gland located in the neck. The thyroid gland is responsible for making hormones that regulate your bodys metabolism, which is the bodys process of creating and using energy.
There are several different disorders that can occur when the thyroid produces too many or too few hormones.
Hypothyroidism, or underactive thyroid, occurs when the thyroid doesnt produce enough hormones. It interferes with the bodys ability to perform normal metabolic functions, such as effectively using energy from food products. Symptoms of hypothyroidism include:
- weight gain
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What Looks Like Parkinsons But Isnt
Dr. Fernandez describes two main Parkinsons mimics:
Essential tremor. Also known as benign essential tremor or familial tremor, this movement disorder causes brief, uncontrollable shaking.
It most often affects your hands, but can also affect your head and neck, larynx and other areas. In rare cases, it affects your lower body as well.
But one clue can help distinguish essential tremor from Parkinsons.
This is not an absolute rule, but if shaking occurs at rest, it often is Parkinsons. And if shaking occurs in action, such as when youre writing or eating, it is essential tremor, Dr. Fernandez says.
About half of those with essential tremor have a family history of the condition.
Unlike Parkinsons, essential tremor is generally not perceived as a progressive disorder, and, if mild, may not require treatment.
Doctors can prescribe medications to reduce shaking, but they are not the same drugs used to treat Parkinsons, he says.
Drug-induced Parkinsons. Along with shaking, this condition may cause many symptoms similar to Parkinsons disease, including stiffness, slow movement, a decrease in facial expression and a change in speech.
As the name suggests, taking certain drugs, most commonly antipsychotics and mood stabilizers, can trigger this condition. How long it takes to develop can vary greatly, depending on which drug youre taking, how long you take it and the dosage.
Your doctor likely will treat drug-induced Parkinsons by adjusting your medication.
What Is The Treatment For Parkinson’s Disease
There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.
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Movement Disorders Similar To Parkinsons
Conditions causing excess movement or decreased movement that are sometimes associated with Parkinson’s disease-like symptoms include:
What Movement Disorder Could I Have?
When making a Parkinson’s diagnosis, your doctor will review your medical history and symptoms, perform a careful neurological exam, and, if necessary, carry out further tests to rule out other movement disorders.
Your symptoms may be caused by a movement disorder other than Parkinson’s disease if:
- You display Parkinson’s disease symptoms and features that are characteristic of an additional movement disorder.
- The results of a brain imaging study or laboratory test, such as a blood test, confirm the presence of another movement disorder.
- Your symptoms do not respond to Parkinson’s disease medication.
Because movement disorders are not all treated the same way, it is important to get a proper diagnosis as early as possible so you can formulate the right treatment plan with your doctor.
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:
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Parkinson’s Disease And Gluten
Some people with Parkinson’s disease believe they might alleviate some of their symptomsor even slow the course of their diseaseby following the gluten-free diet. However, despite what you might have read online about the gluten-free diet, there’s, unfortunately, no medical evidence to back the theory that it might help with Parkinson’s disease.
In fact, medical research indicates people with Parkinson’s disease are no more likely than other people to have celiac disease. Celiac disease requires people to go gluten-free because the ingestion of the protein gluten damages their small intestine.
There’s also currently no medical evidence that people with non-celiac gluten sensitivitya condition in which people react to gluten-containing foods but do not have celiac diseaseare more likely than average to develop Parkinson’s disease. However, research on gluten sensitivity is in its infancy, and no studies have looked specifically to see whether it might be linked with Parkinson’s disease.
So for the vast majority of people, evidence shows that the gluten-free diet most likely won’t help improve Parkinson’s symptoms or slow the course of the disease. However, there are a few isolated cases where it’s possible that going gluten-free might help someone who has been diagnosed with Parkinson’s disease. Read on to learn more.
Poll Finds 1 In 4 People With Parkinson Disease Misdiagnosed
In a poll of people with Parkinson disease, more than 1 in 4 participants reported having been misdiagnosed, with a further 21% having to see their general provider 3 times before being referred to a specialist.
In a poll of people with Parkinson disease , more than 1 in 4 participants reported having been misdiagnosed, with a further 21% having to see their general provider 3 times before being referred to a specialist, according to a report published by The Guardian.
The poll, for the charity Parkinsons UK, included more than 2000 patients with PD . Results showed that among participants who were misdiagnosed, 48% were given treatment for their nonexistent condition, with 36% receiving medication, 6% undergoing operations or procedures, and 6% given both medication and operations/procedures. A decline in health was reported in 34% of those misdiagnosed, and women were shown to be more likely to be misdiagnosed than men.
Katie Goates, MSc, BSc, professional communications and engagement program manager at Parkinson’s UK, highlighted the difficulty in diagnosing PD, which is a complex condition of more than 40 symptoms, as one of the chief reasons behind the polls findings. One of the biggest challenges for Parkinsons research is that there is no definitive test for Parkinsons, and as a result weve heard of people being misdiagnosed with anything from a frozen shoulder or anxiety to a stroke, said Goates.
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I Do My Best To Remain Optimistic And Cling To The Fact That The Parkinsons Diagnosis Is Overturned
Neurologists told me that the three drug components of Stalevo would be out of my system within a few weeks, but my brain only felt clear in February 2016 four months after Id stopped taking it. The huge range of motor and non-motor symptoms persists and other new ones have arrived since my body stopped receiving the added, yet unnecessary, dopamine. I do my best to remain optimistic and cling to the fact that the Parkinsons diagnosis is overturned.
Look out for another article by Joanne in the coming weeks, discussing the issue of misdiagnosis in more depth. Joanne has written about her experiences on her blog here
Is Hypothyroidism The Biggest Medical Misdiagnosis Of All Times
25th of May is traditionally a World Thyroid Day that aims to raise the awareness of thyroid disease. Approximately 750 million people worldwide are affected by thyroid disorders and this number is constantly increasing.
As hypothyroidism reached epidemic proportions so did the medical ignorance and the amount of people who remain undiagnosed and undertreated.
Do you know that preventable medical errors are the third leading cause of death in the USA right after heart attacks and cancer?
The Institute of Medicine previously reported that medical errors cause up to 98,000 deaths in US hospitals every year. However, new estimates show that this number is much higher and is between 210,000 and 444,000.
These statistics are astonishing and you may wonder how this is possible.
According to Forbes:
These people are not dying from the illnesses that caused them to seek hospital care in the first place. They are dying from mishaps that hospitals could have prevented.
What do these errors look like? The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions.
The medication injected into a babys IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside. Sadly, over a thousand people a day are dying from these kinds of mistakes.
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In A Sense The Certainty Of Diagnosis Was Good I Belonged Somewhere
Post-misdiagnosis
I still have no confirmed diagnosis. The swathe of neurological symptoms still persist today some aspects of movement are identified as functional movement disorder, but otherwise it has been a question of ruling in/out alternative causes for some symptoms.
One theory is that an initial brain insult during the 2006 anaesthetic, together with a gastro drug I was taking at the time that has Parkinsonism as a side effect, combined to give me Parkinsons disease. But now this original brain insult plus nine years of my brains neuroplasticity being driven into new behaviours by Parkinsons drugs, plus issues that arose during Parkinsons drug withdrawal are the current neurological problems that I have to contend with.
Fortunately, while there is widespread dysfunction, I have been told that there does not appear to be any brain disease processes associated with these symptoms. Again, there are no tests to prove/disprove this and one remains reliant on the expertise of brilliant neuroscientists.
Parkinsons Disease Can Be Misdiagnosed
In the early stages, it can be difficult to diagnose Parkinsons disease. The early symptoms of the disease can come and go. You might think you are just stiff or having cramps. Or, you might think that this is just part of the aging process. But if the symptoms keep on coming back, you will eventually go to the doctor. He may tell you that it may take more time before he can make a definite diagnosis. This can lead to much anxiety, of course.
If you think you might have Parkinsons disease, below are some things to keep in mind, especially if your doctor has not yet diagnosed you. Remember, diagnosing PD can be hard, even for a highly trained neurologist:
- There are no blood tests or lab tests that can diagnose the disease for certain. It is usually diagnosed based upon medical history, a clinical exam and symptoms.
- Four typical signs of PD are rigidity, slow movement, tremors and postural instability. If you are experiencing these symptoms, especially if they began on one side of the body, your doctor may diagnose you with the disorder.
Note that even if you have three classic symptoms of PD, you still may not have it! To decrease the chance that you will be misdiagnosed, your doctor may have you take several drugs that treat Parkinsons such as levodopa. If your symptoms get better when you take the drug, you probably have PD. If you do not get better after a period of levodopa therapy, your tremors may be due to another cause.
PD and Progressive Supranuclear Palsy
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Possible Mechanisms Of Seizure Disorders In Hashimoto’s Encephalopathy
The mechanisms of seizure disorders in HE are still not fully understood. Possible mechanisms including autoimmune mechanisms may play a variety of roles in the pathophysiology of epilepsy because HE belongs to a spectrum of autoimmune encephalitis . Thyroid-associated antibodies such as TPOAb, thyroglobulin antibody , thyrotropin receptor antibody , and -enolase antibody targets for cortical neurons and endothelial cells were found in HE patients with epilepsy. Although antithyroid antibodies are important when HE is diagnosed, the role in the underlying pathogenesis mechanism remains unclear, and no direct correlation between serum antibody titers and clinical state of disease severity is found. The pathogenic roles of antibodies in HE have been questioned. Rather than playing a direct role in the pathophysiology of HE, it is suggested that thyroid-associated anti-TPO is a hallmark of HE . Yuceyar et al. reported a case with a family history, and they hypothesized that a genetic factor may participate in the pathogenesis of HE . Besides, other research suggested that toxic effects of TSH, brain hypoperfusion, and edema-induced cerebral dysfunction due to autoimmune-mediated vasculitis may also play a role in the mechanisms of seizure disorders .
Parkinson’s Misdiagnosis: Huntington’s Disease
Huntingtons disease causes brain cells to break down. Symptoms can include clumsiness, insomnia, lack of energy, and lack of physical control. Difficulty walking often comes with Huntingtons, which is why it could be a reasonable diagnosis for someone with Parkinsons.
My husband has now passed, but was misdiagnosed with Huntingtons disease.
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Which Test Can Be Done When The Diagnosis Is In Doubt
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: |
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.