Matthew,

Happy New Year!

Thanks for that last update on your mother's condition; it does indeed seem she seems to gain some benefit from the Sinemet...what this means, who knows? Common sense would tell us we need better, more scientifically accurate diagnostic tools beyond clinical observation and response to medicine. I believe DAT brain scans (more sophisticated than MRI) are prevalent there in diagnosis, not here. The machines are still slogging through FDA hoops and insurance companies do not want to pay for the pricy tests. Isn't it ludicrous though your mother could still have the scan, not to find out what she has, but what she does not have. This could alleviate a lot of worry on the part of everyone. You do usually have the option to pay out of pocket, but who has that kind of money and point is that insurers should be covering it; especially in cases not so obviously screaming "PD".

Have you had a chance to follow up with that doctor who was going to review the MRI results?

Beyond this, what does the MDS recommend for further diagnostics? Keep asking "If not PD, then what else might it be?" My GP recommended using that exact wording with specialists, maybe because it doesn't let them so easily off the hook.

In the end, maybe this is all there is to it. It would seem that PD cardinal symptoms seem to emerge in some people as a reaction to some sort of brain trauma or systemic stress. We can't even get everyday, run of the mill stats on PD let alone probable etiologies; the CDC has never collected demographics on us. It does still happen in connection with viral infection to varying degrees...in some people the symptoms clear when infection clears up, while in others it becomes degenerative disease. In these cases, people involved had a range of responsiveness to levodopa. I don't think there have been case studies linking Parkinsonism to anesthesiology, but you never know. Have you tried a search for those terms in Pub Med. This may seem far fetched but stranger things have happened and given no one gives us any thing else plausible...

Not sure how I would proceed if I were in your shoes. It is so frustrating to be put on a diagnostic hold shelf; a lot of times when diagnosis is uncertain the neuro will place you there and then monitor symptomatic changes if any. This is why it is great that you have been absorbing and recording from day one; just keep up the good work.

If you want to, in theory say, operate from premise that your mom still may have regular ol' PD then time is an issue. The only real natural take no meds approach one can take is to either keep exercising or to start moving. It is the only thing out there that shows ability to halt disease progression and spur generation of new neurons. I know it may sound crazy given that she has become barely ambulatory, but it may be something you want to discuss with her physical therapist. I think Wii's are now being studied in clinical trials as therapeutic in PD, so maybe you can make a family game of it?

Best,

Laura