The Use Of Levodopa And Peripheral Neuropathy
There are reports in the literature that levodopa use may increase the risk of peripheral neuropathy, although other studies suggest that this is not the case. There are studies that demonstrate for example, that cumulative Levodopa exposure correlates to prevalence of PN in people with PD. Other studies however, demonstrate no difference in the prevalence of PN whether the person was treated with Levodopa or not, suggesting that Levodopa treatment does not play a role in development of PN.
Another area of research that emerges from the literature is the potential role of Vitamin B12 deficiency in the development of PN in those with PD. Some studies suggest that Vitamin B12 deficiency is a more common cause of PN among those with PD than those with PN who do not have PD.
There is also research that suggests that levodopa treatment may contribute to PN through impairment of Vitamin B12 metabolism, leading to Vitamin B12 deficiency. Taking COMT inhibitors such as Entacapone may protect against this complication.
Regardless, if PN is diagnosed in anyone, whether they have PD or not, and whether they take Levodopa or not, Vitamin B12 and various other markers of Vitamin B12 metabolism should be tested. If Vitamin B12 levels are low or even low-normal, a person should take Vitamin B12 supplementation, which may help with the symptoms of PN. Other causes of PN, many of which can be checked with various blood tests, should be investigated as well.
Report Problems With Your Medications To The Fda
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
For more information, visit the Duke Health Neurological Disorders Center
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Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
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How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.
If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.
Cognitive And Psychiatric Symptoms
- depression and anxiety
- mild cognitive impairment slight memory problems and problems with activities that require planning and organisation
- dementia a group of symptoms, including more severe memory problems, personality changes, seeing things that are not there and believing things that are not true
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Discuss With Your Physician
Non-motor symptoms can sometimes be difficult to recognize. Therefore, it is important to make your doctor aware of them.
One useful resource is the PD NMS Questionnaire. You can use this to record your symptoms and discuss them with your doctor.
Dr. Ron Postuma, whose research was funded by donations to the Parkinson Canada Research Program, has also developed tools to help people with Parkinsons and their physicians identify and manage non-motor symptoms.
The Nervous System And Parkinson’s Disease
the hands and fingers, and their use or lack thereof, have key roles either in the rate of degeneration or in progressive symptom reduction. Indeed, if you’ve ever seen one of those grotesque renderings of how the human body is actually represented by the proportion of brain power devoted to each body part , the hands come out as absolutely massive – hands and neurology are very strongly linked!
Therefore hand exercises and finger stimulation are critically important for preventing the ravishes of neuronal atrophy in PD, and also to strengthen “para-sympathetic tone”, enhancing the ability to maintain a relaxed state, so important for people affected by the disease. Indeed, the story of Chris Lacey is intriguing, with reports he is now free from PD symptoms after intensive carving of chess pieces as a hobby.
The importance of hands and fingers is hence profound for those of us who have been diagnosed with chronic disease.
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Protocol Considerations For Emg
Real-world walking. Investigating gait during real-world activity is desirable to understand motor strategies in a natural environment although current technological limitations make long term recordings challenging.
Sample size. Greater numbers of participants and more stride cycles are necessary.
Muscle selection. Muscles representing all major muscle groups acting on the ankle, knee and hip joints in the sagittal and coronal planes should ideally be recorded to permit analyses of multi-muscle activation patterns and underlying neural control systems to be undertaken.
Electrode placement. A clear statement must be included regarding methods used to identify electrode placement and established guidelines followed.
Longitudinal studies. This will inform us how motor patterns change with age and disease progression and help establish EMG characteristics as biomarkers.
Additional gait and cortical parameters. Parameters such as joint kinematics and kinetics as well as cortical activity measured with mobile, wireless systems such as functional near infrared spectroscopy or electroencephalography will enable us to relate EMG to gait impairment and cortical processes.
Symptoms Of Peripheral Neuropathy
The symptoms of PN can be non-specific, and a person therefore may not be able to distinguish on their own whether his/her symptoms are due to PN or another condition. PN, however, often results in specific findings on a neurologic exam, such as decreased sensation to pin prick or vibration or the lack of ability to discern which way a toe is being pointed without looking. Other tests such as Electromyogram and Nerve conduction studies may be necessary to confirm the diagnosis. Small fiber neuropathy which typically causes pain, burning, tingling and/or numbness in the feet, may have normal EMG and NCS and a skin biopsy may be necessary to confirm the diagnosis. With the appropriate examination and supportive tests however, a neurologist should be able to distinguish the symptoms of peripheral neuropathy from other conditions, including PD, that may cause similar symptoms.
There are many known causes of PN including diabetes, vitamin deficiencies, certain infections, and autoimmune diseases. Many of these causes can be treated, so it is important to know if you do have PN and what the cause is. There are those people however, who have the signs and symptoms of PN, but no known cause can be identified.
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Early Warning Signs Of Parkinson’s Disease
ByJeremy Parker | Submitted On December 03, 2006
Parkinson’s disease develops when the neurons of the substantia nigra in the brain become progressively damaged and depleted. However the first signs of Parkinson’s disease are not obvious until about 80% of these neurons, that are responsible for the production a neurotransmitter called dopamine which helps to control muscle movement, are damaged beyond repair. Thus the early symptoms are actually only seen for the first time quite late on in the disease.
Fortunately there are a number of signs that point towards the development of the disease and so watching out for these can have positive effects on diagnosing Parkinson’s disease as early as possible.
The signs and symptoms of Parkinson’s disease can also be attributed to other illnesses such as stress and absolute exhaustion so many sufferers don’t visit the doctor until such a time as they realise the symptoms are not getting any better, which can be months down the line. Contrary to popular belief, Parkinson’s disease is not age specific and although it is most commonly seen in the older generation there is a growing number of cases that develop earlier on in life, thus if you have any of the signs mentioned above and are in the least bit worried then a trip to your local doctor is advised, even if it is only to put your mind at rest.
What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
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Not Everyone Who Develops Parkinson’s Is Born With It
Scientists still don’t exactly know what causes Parkinson’s disease, although they believe it is a mix of genetics, environmental influences, and lifestyle choices. According to the Parkinson’s Foundation, genetics are likely responsible for about 10 percent to 15 percent of all Parkinson’s cases. Researchers have discovered dozens of gene mutations linked to this disorder, but are still studying what role they play in the disease. And even when someone has a gene mutation associated with Parkinson’s like Ozzy, “the likelihood of developing the disease is low,” according to the foundation.
Ozzy told Good Morning Britain he had known about his gene since 2003, with Sharon adding that Ozzy had always had a “weird way of walking,” which might have been a result of the abnormality. “His doctors think his shock to his body actually started off this Parkin 2 gene,” Sharon said, discussing how he was officially diagnosed with Parkinson’s after his fall and neck surgery.
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Potential Pathogenic Mechanisms Of Peripheral Neuropathy In Idiopathic Parkinsons Disease Patients
The studies to date have been descriptive and associative in nature only. The precise pathogenic mechanisms for the development of peripheral neuropathy in IPD patients remain speculative. Before considering the mechanisms by which methylmalonic acid and/or homocysteine may be pathogenic, other considerations require discussion.
As mentioned, considerations for genetic influences are important. The potential implications of parkin mutations given the expression of parkin mRNA in peripheral nerve may be of importance, but only a small percentage of IPD patients with parkin mutations appear to have an axonal form of peripheral neuropathy . The relationship of concurrent peripheral neuropathy to the so called Parkinsons Plus forms of disease, such as with multiple system atrophy must also be considered patients with multiple system atrophy frequently have an axonal peripheral neuropathy present . Associations such as this may suggest a neurodegenerative pathogenesis for peripheral neuropathy rather than a deficiency. Indeed, patients with greater severity and longer duration of IPD were more susceptible to development of peripheral neuropathy in our studies as well . Further studies will be required to determine if the peripheral neuropathy present in IPD patients develops in an analagous fashion to the central nervous system neurodegeneration in IPD.
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Social Engagement And Parkinson’s Disease
See the groundbreaking work of Dr Stephen Porges to understand more about this aspect of our Nervous System and its role in wellness and disease, based on the fact that mammals have a more evolved part of the Nervous System specifically designed for purposes of Social Engagement and Social Co-operation.
Social Engagement involves mainly the Cranial Nerves and their use in social functions such as making sounds and vocal calls for communication, and in facial expressiveness for transmitting emotional states to each other. Dysregulation of this Social Engagement part of our NS seems now to be a principal underlying cause in many chronic conditions, especially in PD, where loss of voice and loss of facial expression are major symptoms. See
Hand And Finger Stimulation Exercises
I have done a lot of hand/finger stimulation and experimented to optimize such exercises, in the spirit of Curiosity and Play. I’ve personally found significant benefit in pursuing this line of research. Indeed, I have managed to recover a lot of my independence and quality of life through hand and finger therapy, and I know just how much of a major part it has played in my own progressive symptom reduction.
I therefore encourage everyone with PD to do as much hand and finger stimulation as possible, through games and play and self-discovery. By doing nothing, the only thing that will happen is that out situation will rapidly become worse, because we will lose the use of our hands quicker and consign ourselves to increased suffering. By applying neuroplasticity techniques , we can delay the worse ravishes of the disease or even, like in my own case, continuously push the symptoms back and recover some independence. I feel this is an important message for those newly diagnosed, in particular.
Here are some suggestions of the type of stimulatory exercises and games which can help, more ideas which I have personally found beneficial will be provided in forthcoming articles.
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How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
But There Are Typical Signs Of Parkinson’s Everyone Should Look Out For
With various types of Parkinson’s disease, signs and symptoms can be different for everyone, according to the Mayo Clinic. Nevertheless, there are some telltale signs that something may be amiss. For most cases, symptoms usually begin on one side of your body and usually remain worse on that side, even if they eventually begin to affect both sides. These could include a tremor in one of your limbs , slowed movement, rigid muscles, impaired posture and balance, loss of automatic movements, speech changes, and writing changes. You could even experience numbness or cold sensations, like Ozzy.
If you have any symptoms associated with Parkinson’s disease, you should talk to your doctor so they can not only diagnose your condition, but rule out any other causes for your symptoms, the Mayo Clinic advises.
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Numbness Or Tingling In Your Hands Could Be Early Signs Of Ms
Amber O’Brien, MD, a doctor at Mango Clinic, says numbness and tingling in your hands are some “of the earliest signs that appear in MS.” The severity of the numbness and tingling can vary greatly. “A tingling in the hand may sometimes be a niggling inconvenience, or it might make holding things difficult or very painful,” the MS Society says.
According to the Mayo Clinic, these symptoms are the result of the immune system attacking the protective coverings on nerves, which leads to communication problems between your brain and other parts of your body.
What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
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