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What would be the best "next steps" if I am presenting most

Hello, what would be the...
Hello, what would be the best "next steps" if I am presenting most if not all of the symptoms for Parkinsons. I have been evelauated for RA, MS and Lupus so far.
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have not seen a dr specifically for this but rather trying to pinpoint the issue. I was on Gabapentin but did not like the side effects.
JA: Anything else in your medical history you think the doctor should know?
Customer: Nothing earth shattering. I am just very frustrated with these symptoms and seem to be going in circles with different doctors. Just recently a family friend noticed some parkinsons symptoms in me and asked if i had been seen for that.
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Answered in 1 hour by:
11/18/2017
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,691
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about your health in the form of frustrating symptoms and I see you are also wondering whether you are a case of parkinson’s. As a neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

I am currently preparing & typing my answer and I will post my answer here as soon as it is ready.

Best Regards!

Dr Subbanna MD

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I am almost done with my typing; I will follow up with you very soon.

Best Regards!

Ask Your Own Neurology Question

Once again I am sorry to hear about your health in the form of frustrating symptoms and I see you have been wondering whether you are a case of parkinson’s.

Please see parkinson’s is a disease affecting a region of the brain called as basal ganglia.

The primary underlying pathology of this condition involves a deficiency of a neurochemical or neurotransmitter called as dopamine.

And there are various kinds of parkinon’s, one of them the typical one is called as parkinson’s disease (PD), then there are many other types grouped under the broad umbrella term called as secondary parkinson’s, or parkinsonian syndrome, or parkinsons’ plus syndrome etc

Now coming to the symptoms of Parkinson's condition, symptoms include one or more of the following;

Tremors (resting type, means occur when the hand is in a resting position and the tremor generally subsides or disappears when actively using the hand)

Bradykinesia or akinesia (slowing of daily motor activities or more than normal time taken to finish a motor task like walking, chewing, swallowing etc)

Reduced swinging of the arms while walking

Muscle rigidity (stiffness)

Difficulty with walking and sometimes tendency to fall

Stooping posture (bending forward while walking)

Shuffling gait (short stepped gait)

Difficulty with writing (usually writing in small letters called as micrographia)

Speech difficulties (usually speaking in low volume called as hypophonoia)

Mask like face (less expression on the face, less blinking than normal of the eye lids) etc.

Not all patients may manifest with all these above mentioned symptoms, especially in the early stages, but if all these manifestations are present, or at least couple of the typical manifestations are present then the diagnosis is very straightforward.

Regarding the diagnosis of parkinson's it is mostly a clinical diagnosis. A thorough history followed by a detailed clinical examination by a neurologist in the clinic will help in establishing the diagnosis of this condition.

Regarding investigations – investigations are generally not necessary with straightforward cases, because the parkinson’s disease diagnosis is mostly a clinical diagnosis, and many investigations may not be helpful too as pointed below.

There are no blood tests that are useful in ruling in or ruling out of Parkinson’s disease and brain scans like MRI (or CT) scan of the brain is expected to come normal in typical PD, but it is sometimes ordered to rule out any structural abnormalities in the brain that can sometimes produce a parkinson’s disease like picture. If such structural abnormalities are identified on the brain scan as a cause for the parkinson’s then it is called as secondary parkinsonism and such conditions are treated accordingly. If MRI (or CT) comes normal then the parkinson’s disease diagnosis will stay, provided the clinical picture is also very typical for this disease. For the secondary parkinsonian conditions, or parkinson’s plus syndromes etc, more investigations may be necessary.

Sometimes in very difficult cases a special brain scan called as DaTscan of the brain which is a type of SPECT scan of the brain and it can be used to assist with the diagnosis of the parkinson’s conditions.

If you are suspecting parkinson’s then please try to see a neurologist in the clinic and the neurologist will examine you in the clinic and after that will arrange for any neurological investigations as necessary and will finalize the diagnosis.

Regarding the treatment of parkinson’s;

Once the diagnosis of parkinson’s is confirmed then it is usually treated with one or more medications such as the following;

Requip

Mirapex

Levodopa/carbidopa

Rasagiline etc

Physical therapy, gait & balance training is also strongly recommended if you are also having lot of gait issues.

Of course if the disease is at a mild or early stage then you do not need any medications, just physical therapy is what is recommended, however if there are more severe symptoms then in addition to the physical therapy and exercises additional treatments mentioned above are necessary too.

If you are concerned about parkinson’s possibility in you (and if you have any of the symptoms of parkinson’s I mentioned above) then you may please discuss all these above points with a clinic-neurologist for the further needful (clinical examination, investigation & appropriate treatments as discussed above).

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Hi, I earnestly hope you find the above posted information helpful related to the best “next steps” towards getting properly evaluated & investigated for the possibility of Parkinson’s in you.

Do you have any additional health questions? Do you want to discuss this health situation further? Please let me know and I am available here.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Customer reply replied 22 days ago
Thank you for all of the information. i have made an appointment with a neurologist.
Thank you again,
Audra

You are very welcome Audra! I am very glad to hear you found the above information helpful!

Yes, I fully concur with your plan of seeing a neurologist, and this can help you in receiving the precise diagnosis and the neurologist can also assist you with the appropriate treatment of your health condition.

Please let me know if you have any additional questions or if you want to discuss this further. And please do not forget to take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Wishing you all the very best!

Thanks & Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,691
Experience: American Board Certified Neurologist, Internal Medicine
Verified
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Dr Subbanna MD
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,691
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