Thursday, January 26, 2023

Non Shaking Parkinson’s Disease

The Right Diagnosis Can Save Time

Parkinson’s Disease Patient: Balance, Gait, and Tremors Improve with New Non-Surgical Treatment

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.

Diagnosing Parkinsons Vs Essential Tremor

The difference between essential tremor and Parkinsons can be so slight that it can be difficult for doctors to diagnose these conditions correctly. In fact, they are often mistaken for one another, which can be frustrating for physicians and patients alike. Specialty physicians that diagnose and treat these conditions are Movement Disorder Neurologists.

While there are no official tests for either condition, there are several diagnostic techniques that physicians employ to attempt properly diagnose essential tremor vs. Parkinsons, including:

  • Physical examination: During a physical examination, a physician evaluates the patients motor skills to help in their determination of whether they suffer from essential tremor vs. Parkinsons.
  • DaTscan: During a DaTscan, a radioactive tracer is injected, which makes its way into the brain, where it attaches to dopamine transporters. Special imaging scans are then conducted to see whether the dopamine system is healthy. If it is irregular, it may help diagnose your condition as Parkinsons.
  • Handwriting sample evaluation: A doctor may be able to differentiate Parkinsons vs. essential tremor using a handwriting sample because those with Parkinsons typically exhibit exceptionally small handwriting, whereas those with ET exhibit larger, shaky handwriting.

Why Is Proper Follow

A person with Parkinsons disease is supposed to go for regular checkups to the health care professional for the following reasons-

Check-up: The check-ups help the health care professionals to check if the treatment procedure is working or not and also provides an insight about the necessary adjustments to be made.

Follow-ups- Regular follow-ups help in detection of new problems with cognition, behavior or mood which might need special treatment.

Analysis: The follow-ups provide a platform for caregivers to discuss the problems with respect to the patients care.

Progression of Dementia: It can also be known if the patient is susceptible to dementia with the help of regular checkups.

It may happen so that the person with Parkinsons disease developing dementia may not be able to take care of himself or take decisions about his healthcare. Thus, caregivers should be extra careful and follow the regular follow-ups with the doctor.

Also Read:

Don’t Miss: How To Test Yourself For Parkinson’s

General Approach To Management

The primary goal in the management of PD is to treat the symptomatic motor and nonmotor features of the disorder, with the objective of improving the patients overall quality of life. Appropriate management requires an initial evaluation and diagnosis by a multidisciplinary team consisting of neurologists, primary care practitioners, nurses, physical therapists, social workers, and pharmacists., It is also important that the patient and his or her family have input into management decisions.

Effective management should include a combination of nonpharmacological and pharmacological strategies to maximize clinical outcomes. To date, therapies that slow the progression of PD or provide a neuroprotective effect have not been identified., Current research has focused on identifying biomarkers that may be useful in the diagnosis of early disease and on developing future disease-modifying interventions.,

How Is Anxiety Diagnosed

Figure 1 from The relationship between essential tremor ...

Anxiety is usually diagnosed by a primary care physician, or a mental health professional, who will ask questions about certain symptoms. The doctor will talk with the patient about mood changes and behaviors. For people with an anxiety disorder, their symptoms become so intense that they are unable to function normally in life. Overall, it is easier to diagnose anxiety than depression in PD, because symptoms of anxiety and PD do not overlap as much.

In general, symptoms of anxiety may include:

  • Excessive fear and worry
  • Dizziness
  • Nausea

In people with Parkinsons, a diagnosis of an anxiety disorder is made only if the symptoms involve a clear change in a patients previous behavior and are not easily confused with motor symptoms. For example, even though a patient may have a legitimate concern that a tremor or change in walking ability may be noticed in public, a diagnosis of social avoidance is only made if the patient realizes that the concern is excessive, the social situation is avoided, and it causes interference in the persons social or work life.

Read Also: Why Does Parkinson’s Cause Hallucinations

Parkinson’s Disease Symptoms Everyone Should Know

Parkinsons disease symptoms can include tremor and trouble with movement, along with emotional and cognitive changes.

Parkinson’s disease symptoms can vary significantly from person to person. Some people may have range of motor symptoms, like tremor, stiffness, and slow movements. Others may also experience the non-motor symptoms of Parkinson’s disease, such as anxiety, cognitive changes, and loss of smell.

It has to do with a chemical messenger known as dopamine, which plays a role in the brain’s ability to control movement, coordination, and emotional responses. In Parkinson’s disease, the brain cells that produce dopamine either stop doing their job or they die out, resulting in both motor and non-motor symptoms. It’s not always easy to tell if someone you care about has Parkinson’s disease. Let’s take a closer look at the symptoms of the disease and signs that someone should make an appointment with their doctor.

How Is Parkinson’s Disease Diagnosed

A person doesn’t need to have all the signs and symptoms of Parkinson’s disease to be diagnosed with it.

“In general, people have a combination of the motor symptoms and the non-motor symptoms,” says Dr. Nwabuobi. “Some people have more non-motor symptoms than motor and vice versa, but in order to have a diagnosis of Parkinson’s, you definitely need the motor symptoms. We’re looking for specific things , including a rest tremor, bradykinesia, rigidity, and poor balance.”

According to the Parkinson’s Foundation, a person needs to have two of the four main motor symptoms of Parkinson’s over a period of time to be diagnosed with the disease.

You May Like: Young Onset Parkinson’s Symptoms

Getting Treatment: Essential Tremor Vs Parkinsons Disease

There is currently no cure for essential tremor or Parkinsons. However, that does not mean you have no control over your condition. As doctors learn more about these conditions, developments in treatment and disease management continue to help patients preserve their quality of life as much as possible.

Treatments For Parkinsons Disease

Parkinson’s disease symptoms of lip tremor and shuffling gait disorder with new treatment

While currently available Parkinsons treatments cannot slow or halt the disease, they can help manage symptoms. According to the American Parkinson Disease Association, here are some of the most common treatment options:

  • Oral Medications: As far as medications for Parkinsons disease are concerned, Carbidopa/Levodopa are considered to be the most effective. However, it can also be used in combination with other medications as recommended by your doctor.
  • Surgery: Similarly to essential tremor, deep brain stimulation is also a surgical treatment option for patients with Parkinsons.
  • Physical and Speech Therapy: In addition to medications, physical and speech therapy can help those with Parkinsons maintain better control over their movements, voice level, and ability to speak clearly.
  • There are also lifestyle changes that you can make to help with your Parkinsons symptoms, including:

    • Practicing strength training to help with movement
    • Stretching to help with rigidity
    • Getting massages to relieve muscle stiffness and stress
    • Eating a healthier diet to help with lethargy

    While these are the most commonly recommended treatment options for Parkinsons disease right now, there is a lot of effort and financial support toward finding new solutions, including clinical trials of medications.

    You May Like: Botox For Drooling In Parkinson’s

    Weakening Sense Of Smell And Taste

    This may be due to degeneration of the anterior olfactory nucleus and olfactory bulb, one of the first parts of the brain affected by Parkinsons. This can happen so gradually that youre not even aware of it.

    Losing your sense of smell and taste can make you lose interest in food. You may miss out on important nutrients and lose weight.

    Signs & Symptoms: Is It Essential Tremor Or Parkinsons

    In order to start managing your condition and receive the treatment you need, you should be aware of the most common signs and symptoms as well as the key differences between essential tremor and Parkinsons. After all, the first step in getting care as early on as possible is self-awareness that you might be suffering from one of these conditions.

    Recommended Reading: Late Stage Parkinson’s Disease Symptoms

    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.

    Conflict Of Interest Statement

    Does Parkinson

    Vanderbilt University receives income from grants and contracts with Allergan, Ipsen, Lundbeck, Merz, Medtronic, and USWorldMeds for research or educational programs led by DC. DC receives income from Allergan, Alliance for Patient Access, Ipsen, Medtronic, and Revance for consulting services.

    The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

    Don’t Miss: How Do They Check For Parkinson’s Disease

    Treatments For Essential Tremor

    According to Harvard.edu, there are several actions that can be taken to help manage your essential tremor and minimize how they impact your daily life. First, lets cover treatment options:

  • Oral Medications: Propranolol and primidone are considered to be the most effective treatments for essential tremor, reducing tremors as much as 50%. Propranolol is a beta-blocker and primidone is an anti-seizure medication.
  • Surgical Treatment: In cases where essential tremor does not respond to medication, surgery may be recommended. There are invasive techniques, such as deep brain stimulation, that can be used to help reduce tremors. However, brain surgery is not without its serious risks.
  • Non-Invasive Therapy with Cala Trio: Cala Trio is a wrist-worn non-invasive therapy device that is calibrated to relieve hand tremors. It works by delivering surface stimulation at your wrist, which is believed to disrupt the central tremor network in your brain. In one clinical study, 64% of patients reported tremor relief and the average reported time was 94 minutes. Available only by prescription, the Cala Trio wrist-worn device provides on-demand tremor relief.
  • As each patient is different, you and your doctor will need to decide what the best course of action is for you. You must weigh the pros and cons of each treatment option based on your lifestyle and how you think theyll impact your quality of life.

    The Evolution Of Treatments

    The history of Parkinson’s disease is tightly linked to therapeutic interventions, ranging from serendipitous observations to controlled clinical trials of specifically designed agents.

    Parkinson devoted a chapter of his monograph to considerations respecting the means of cure . In humility and perhaps with a vision toward current concepts of neuroprotection, he hoped for the identification of a treatment by which the progress of the disease may be stopped . To this end, he advocated very early therapeutic intervention when signs were largely confined to the arms without balance and gait impairments. Reflecting therapeutic approaches of the early nineteenth century, Parkinson recommended venesection, specifically advocating bloodletting from the neck, followed by vesicatories to induce blistering and inflammation of the skin. Small pieces of cork were purposefully inserted into the blisters to cause a sufficient quantity of purulent discharge . All these efforts were designed to divert blood and inflammatory pressure away from the brain and spinal cord, and in this way, decompress the medulla that Parkinson considered the seat of neurological dysfunction.

    Also Check: Gift Ideas For Parkinson Patients

    Causes: Parkinsons Vs Essential Tremor

    The cause is largely unknown for both Parkinsons and essential tremor. However, there are theories about what may cause these conditions.

    In regards to essential tremor, John Hopkins Medicine notes that there is a theory that the condition may be caused by miscommunication between the cerebellum and other parts of the brain. There is also believed to be a genetic predisposition for developing essential tremor. You may be 50% more likely to develop essential tremor if your parent has the condition.

    It is also important to note that certain factors can also cause other types of tremors. For example, according to the National Institute of Neurological Disorders and Stroke, certain medications, thyroid overactivity, and toxins like lead and mercury can produce tremors that might be confused with this condition.

    In regards to what causes Parkinsons disease, the direct cause as to why specific individuals develop Parkinsons is unknown. However, what happens within the body that causes Parkinsons symptoms to manifest, is the gradual loss of brain cells that are responsible for producing dopamine. When this happens, it can interfere with normal body movement, leading to patients to exhibit the common symptoms of Parkinsons.

    Can Parkinsons Disease Be Prevented

    Parkinson’s Disease Symptoms: Tremor, Posture, Gait and Balance Improve with TMJ Treatment

    Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.

    Don’t Miss: Grants For Parkinson’s Patients

    When To See Your Doctor

    Its easy to assume these problems have other causes, and they often do. But any of these non-motor symptoms can have a big impact on your overall quality of life.

    Having one or more doesnt necessarily mean you have Parkinsons disease or that youll eventually develop it. But its worth consulting with your doctor.

    Tell your doctor if youre concerned about having Parkinsons disease. Although theres no cure, there are medications to help control symptoms.

    Contact Our Information And Referral Helpline

    The Parkinson Canada Information and Referral Helpline is a toll-free Canada-wide number for people living with Parkinsons, their caregivers and health care professionals. We provide free and confidential non-medical information and referral services. When you have questions or need assistance, our information and referral staff help connect you with resources and community programs and services that can help you. We provide help by phone or email, Monday to Friday, 9:00 a.m. 5:00 p.m. ET.

    You May Like: Are Weak Legs A Sign Of Parkinson’s

    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.

    What To Expect From Diagnosis

    Parkinson

    Theres no single test for Parkinsons, so it can take some time to reach the diagnosis.

    Your doctor will likely refer you to a neurologist, who will review your symptoms and perform a physical examination. Tell your doctor about all the medications you take. Some of these symptoms could be side effects of those drugs.

    Your doctor will also want to check for other conditions that cause similar symptoms.

    Diagnostic testing will be based on your symptoms and neurologic workup and may include:

    • blood tests

    Recommended Reading: What Is Parkinson’s Disease And How Do You Get It

    What Is A Parkinsons Tremor

    Other health issues can also cause tremors, like multiple sclerosis or essential tremor. But Parkinsonâs tremors are different because theyâre usually:

    • Resting. Parkinsonâs tremors happen when your muscles are still. They go away when you move. They also lessen while you sleep. For example, if youâre sitting in a chair with your arm relaxed, you may notice that your fingers twitch. But if youâre using your hand, like when you shake someone elseâs hand, the tremor eases or stops.
    • Rhythmic. Parkinsonâs tremors are slow and continuous. They arenât random tics, jerks, or spasms.
    • Asymmetric. They tend to start on one side of your body. But they can spread to both sides of the body.

    What Are The Various Stages Of Parkinsons Disease And The Symptoms Associated With It

    The progression of Parkinsons disease is mostly divided into five stages-

    Stage 1- This stage is characterized by the mildest form of Parkinsons. The symptoms are not so severe to interfere with daily tasks and overall lifestyle. Friends and family members may notice some sort of changes in the way the patient walks, his posture and some facial expression. One of the distinct symptom of Parkinsons is the tremors are other problems in movement and exclusive to one side of the body. If doctor is consulted at this stage, the prescribed medication can help ease out the symptoms at this stage.

    Stage 2- This phase is considered to be the moderate form of Parkinsons because the symptoms get distinctively noticed by people. Muscle stiffness is quite common at this stage. It must be remembered that although there may be an increase of tremors and irregular posture, stage 2 does not impair the balance of the patient.

    Stage 3- The patient may experience a turning point in this stage as along with the symptoms he may not be able to maintain his balance and experience decreased reflexes. Movements become slower and falls become common. Medication along with occupational therapy may be advised.

    Stage 4- It becomes impossible to even stand without assistance at stage 4. Living alone may make daily tasks impossible and dangerous. Thus the patient will need a caregiver from this stage.

    You May Like: Are There Service Dogs For Parkinson’s Patients

    Popular Articles
    Related news