Parkinson's Disease Tulip


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Old 05-13-2007, 04:30 PM #41
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Are we really discussing whether or not Parkinson's existed prior to being studied by Dr. Parkinson?
There are medical treaties from ancient Rome recommending white beans (faba, fabae) to treat "paralysis agitans". It's as old as humanity.
Helloooo! Ever read Dickens et al.? Until very recently it used to be called "shaking palsy" ("Perlesía" in Spanish and "Schüttellähmung" in German). I believe the term Parkinson's was implemented worldwide in the second half of the 20th Century when medical research went global.
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Old 05-13-2007, 04:57 PM #42
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Lightbulb hello tex -

we are discussing if we have actually have been given the correct diagnosis -
and if so did we ever have PD -

I found a 1927 journal from English Doctor describing a male patient
online called HemiChorea -this is a pdf from the Oxford Journals.
http://brain.oxfordjournals.org/cgi/...e2=tf_ipsecsha



Chorea -
Definition

Chorea refers to brief, repetitive, jerky, or dancelike uncontrolled movements caused by muscle contractions that occur as symptoms of several different disorders. The English word "chorea" itself comes from the Greek word choreia, which means "dance." The symptom takes its name from the rapid involuntary jerking or twitching movements of the patient's face, limbs, and upper body.

Description

A patient with chorea may appear restless, fidgety, or unable to sit still. The body movements are continually changing and may appear to move from one part of the body to another. Jerking or twitching of the hands and feet may resemble piano playing or dancing. The patient may assume strange postures or make clumsy or wide-swinging leg movements when trying to walk. If the chest muscles are affected, the patient may have difficulty speaking normally, or make grunting or groaning noises. Facial expressions may be distorted by twitching of the lips, cheeks, eyebrows, or jaw. In severe cases, involuntary movements of the arms and legs may result in falling on the ground or throwing objects placed in the hand.

Other symptoms that may occur together with chorea include athetosis, which refers to slow, sinuous, writhing movements of the hands and feet, and ballismus, which refers to violent flinging or flailing of the limbs. A patient with one of these symptoms in addition to chorea may be said to have choreoathetosis or choreoballismus.

In some cases, only one side of the patient's body is affected by the involuntary movements. This condition is known as hemichorea.

Causes and associated disorders

The basic cause of choreic movements is overactivity of a neurotransmitter called dopamine in a set of structures deep within the brain known as the basal ganglia. The basal ganglia belong to a larger part of the nervous system that controls the muscles responsible for normal movement.

Several different unrelated disorders and conditions may lead to imbalances of dopamine in the basal ganglia, including:

Huntington's chorea (HC), an incurable hereditary disorder caused by a mutation in a gene on the short arm of human chromosome 4. It is characterized by dementia and psychiatric disturbances as well as chorea.
Sydenham's chorea, a treatable complication of rheumatic fever following a streptococcal throat infection. It occurs most often in children and adolescents.
Chorea gravidarum or chorea occurring in the first three months of pregnancy. It is most likely to affect women who had rheumatic fever or Sydenham's chorea in childhood.
Senile chorea, which is gradual in onset, is not associated with other causes of chorea, does not cause personality changes, and develops in people over the age of 60. At one time, senile chorea was thought to be a late-onset form of HC, but is presently considered to be the result of a different genetic mutation.
Blockage or rupture of one of the arteries supplying the basal ganglia.
Metabolic disorders. About 2% of patients with abnormally high levels of thyroid hormone (hyperthyroidism) develop chorea. Abnormally low levels of calcium (hypocalcemia) may also produce chorea.
Infectious diseases that affect the central nervous system. Chorea may be a symptom of viral encephalitis or late-stage neurosyphilis.
Medications. Some drugs, most commonly those used to treat psychotic disorders or Parkinson's disease, cause chorea as a side effect. Other drugs that sometimes cause chorea include anticonvulsants (antiepileptic drugs), lithium, amphetamines, and some antinausea medications.
Diagnosis

A doctor diagnosing the cause of chorea is guided by such factors as the patient's age and sex as well as medication history and family history. A patient with symptoms of Huntington's chorea is typically an adult over 35, whereas Sydenham's chorea most often occurs in children aged six to 14. Huntington's chorea affects both sexes equally, whereas Sydenham's chorea affects girls twice as often as boys. A patient with a family history of Huntington's can be given a blood test to detect the presence of the gene that causes HC. A history of a recent throat infection or rheumatic fever suggests Sydenham's chorea. Metabolic disorders can be detected by blood tests.

Hemichorea or chorea accompanied by ballismus may indicate a vascular disorder affecting the basal ganglia, particularly when the chorea is sudden in onset. The doctor will order imaging studies, usually computed tomography (CT) scans or magnetic resonance imaging (MRI) if an arterial blockage or rupture is suspected. Neurosyphilis and encephalitis are diagnosed by testing a sample of the patient's cerebrospinal fluid.

Treatment

In general, chorea is not treated by itself unless the movements are so severe as to cause embarrassment or risk injury to the patient. Drugs that are given to treat chorea suppress the activity of dopamine in the basal ganglia but may also produce such undesirable side effects as muscular rigidity or drowsiness. These drugs cannot be given to women with chorea gravidarum because they may harm the fetus; pregnant patients may be given a mild benzodiazepine tranquilizer instead. Drugs given to treat patients with HD may help to control chorea, but cannot stop the progression of the disease.

Prognosis

The prognosis of chorea depends on its cause. Huntington's chorea is incurable, leading to the patient's death 10–25 years after the first symptoms appear. Almost all children with Sydenham's chorea, however, recover completely within one to six months. Chorea gravidarum usually resolves by itself when the baby is born or shortly afterward. Chorea caused by a vascular disorder may last for six to eight weeks after the blockage or rupture is treated. Chorea associated with metabolic disorders usually goes away when the chemical or hormonal imbalance is corrected.

Resources

BOOKS

"Disorders of Movement." The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2002.

Martin, John H. Neuroanatomy: Text and Atlas, 3rd ed. New York: McGraw-Hill, 2003.

"Movement Disorders: Choreas." The Merck Manual of Geriatrics, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

"Sydenham's Chorea (Chorea Minor; Rheumatic Fever; St. Vitus' Dance)." The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 2002.

PERIODICALS

Caviness, John M., MD. "Primary Care Guide to Myoclonus and Chorea." Postgraduate Medicine 108 (October 2000): 163–172.

Grimbergen, Y. A., and R. A. Roos. "Therapeutic Options for Huntington's Disease." Current Opinion in Investigational Drugs 4 (January 2003): 51–54.

Jordan, L. C., and H. S. Singer. "Sydenham Chorea in Children." Current Treatment Options in Neurology 5 (July 2003): 283–290.

Karageyim, A. Y., B. Kars, R. Dansuk, et al. "Chorea Gravidarum: A Case Report." Journal of Maternal-Fetal and Neonatal Medicine 12 (November 2002): 353–354.

Sanger, T. D. "Pathophysiology of Pediatric Movement Disorders." Journal of Child Neurology 18 (September 2003) (Supplement 1): S9–S24.

Stemper, B., N. Thurauf, B. Neundorfer, and J. G. Heckmann. "Choreoathetosis Related to Lithium Intoxication." European Journal of Neurology 10 (November 2003): 743–744.

OTHER

Herrera, Maria Alejandra, MD, and Nestor Galvez-Jiminez, MD. "Chorea in Adults." eMedicine, 1 February 2002 (April 27, 2004.) http://www.emedicine.com/neuro/topic62.htm.

National Institute of Neurological Disorders and Stroke (NINDS). NINDS Chorea Information Page. (April 27, 2004). http://www.ninds.nih.gov/health_and_...ers/chorea.htm.

Ramachandran, Tarakad S., MD. "Chorea Gravidarum." eMedicine, 9 June 2002 (April 27, 2004). http://www.emedicine.com/neuro/topic61.htm.

ORGANIZATIONS

American Geriatrics Society (AGS). Empire State Building, 350 Fifth Avenue, Suite 801, New York, NY 10118. (212) 308-1414; Fax: (212) 832-8646. info@americangeriatrics.org. http://www.americangeriatrics.org.

Huntington's Disease Society of America (HDSA). 158 West 29th Street, 7th Floor, New York, NY 10001-5300. (212) 242-1968 or (800) 345-HDSA; Fax: (212) 239-3430. hdsainfo@hdsa.org. http://www.hdsa.org.

National Institute of Neurological Disorders and Stroke (NINDS). 9000 Rockville Pike, Bethesda, MD 20892. (301) 496-5751 or (800) 352-9424. http://www.ninds.nih.gov.

Worldwide Education and Awareness for Movement Disorders (WE MOVE). 204 West 84th Street, New York, NY 10024. (212) 875-8389 or (800) 437-MOV2. wemove@wemove.org. http://www.wemove.org.


Rebecca Frey, PhD
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Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.
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Old 05-13-2007, 05:05 PM #43
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Lightbulb the shaking palsy -James Parkinson

222 J Neuropsychiatry Clin Neurosci 14:2, Spring 2002
NEUROPSYCHIATRY CLASSICS

Neurodegenerative Disorders:

James Parkinson’s Essay on
the Shaking Palsy


Thomas C. Neylan, M.D., Section Editor

James Parkinson (1755–1824)

is considered the father of
modern paleontology and a pioneer in geology, pediatrics,
child welfare, and physical chemistry.
1
However,
in our field, he is best known for the disorder that bears
his name. Parkinson’s disease is a prototypical neuropsychiatric
disorder that affects multiple systems regulating
motor function, mood, perception, and cognition.
2
Parkinson’s original description of the disorder, reprinted
here, was published in 1817 as a short monograph
in London.
3
Parkinson was an astute observer whose report contains
observations from three patients he sawin his
clinic as well as three individuals he observed on city
streets. Much of the description of the longitudinal
course of the illness was derived from his observations
of a single case
(Case I). His original report has clear
descriptions of resting tremor, rigidity, and disturbances
in gait and posture. He speculated that the pathology of
the disorder would be localized to the medulla. He appealed
for future anatomic studies to examine the neural
substrate of the disorder.

For fifty years after publication, there was little attention
paid to this report.
4
In 1861, Charcot and colleagues
at the Salpeˆtrie`re further distinguished the disorder
from other neurologic disorders and were first to use
the term “Parkinson’s disease.”
5
References
1. Pearn J, Gardner-Thorpe C: James Parkinson (1755–1824): a pioneer
of child care. J Paediatr Child Health 2001; 37:9–13
2. Cummings JL: Understanding Parkinson disease. JAMA 1999;
281:376–378
3. Parkinson J: An Essay on the Shaking Palsy. London, Sherwood,
Neely and Jones, 1817
4. Louis ED: The shaking palsy, the first forty-five years: a journey
through the British literature. Mov Disord 1997; 12:1068–1072
5. Goetz CG, Chmura TA, Lanska DJ: The history of Parkinson’s
disease: part 2 of the MDS-sponsored History of Movement Disorders
Exhibit, Barcelona, June 2000. Mov Disord 2001; 16:156–
161
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Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.
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Old 05-13-2007, 05:17 PM #44
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I guess I should have read the whole thread! Jeez!
Chorea, or Huntington's Chorea, or Huntington's Disease, or Sydenham's Chorea are convulsive type diseases that were vulgarly known as St. Vitus' Dance.

There is a big difference between Choreas and Parkinson's, plainly visible even to untrained eyes. Even though some of us parkies develop "choreic movements", they're always brought about by levadopa therapy, not by PD itself. If a neuro can't tell the difference, he/she should urgently go back to medical school.
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Old 05-13-2007, 05:27 PM #45
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Post actually it was Dr. Charcot and colleagues that not only studied PD & Hysteria's cure



Dr. Martin Charcot (1825-1893)

was

world-renowned, the most celebrated doctor of his time. He practiced in the Paris hospital La Salpetriere. He became an expert in hysteria, diagnosing an average of 10 hysterical women each day, transforming them into “iatrogenic monsters” and turning simple “neurosis” into hysteria.(96) The number of women diagnosed with hysteria and hospitalized rose from 1% in 1841 to 17% in 1883. Hysteria is derived from the Latin “hystera” meaning uterus. According to Dr. Adriane Fugh-Berman, US medicine has a tradition of excessive medical and surgical interventions on women. Only 100 years ago, male doctors believed that female psychological imbalance originated in the uterus. When surgery to remove the uterus was perfected, it became the “cure” for mental instability, effecting a physical and psychological castration. Fugh-Berman notes that US doctors eventually disabused themselves of that notion but have continued to treat women very differently than they treat men.(97) She cites the following statistics:

Thousands of prophylactic mastectomies are performed annually.
One-third of US women have had a hysterectomy before menopause.
Women are prescribed drugs more frequently than are men.
Women are given potent drugs for disease prevention, which results in disease substitution due to side effects.
Fetal monitoring is unsupported by studies and not recommended by the CDC.(98) It confines women to a hospital bed and may result in a higher incidence of cesarean section.(99)
Normal processes such as menopause and childbirth have been heavily “medicalized.”
Synthetic hormone replacement therapy (HRT) does not prevent heart disease or dementia, but does increase the risk of breast cancer, heart disease, stroke, and gall bladder attack.(100)
As many as one-third of postmenopausal women use HRT.(101,102) This number is important in light of the much-publicized Women's Health Initiative Study, which was halted before its completion because of a higher death rate in the synthetic estrogen-progestin (HRT) group.

this guy was the one that continued the study of PD
this does not make me feel rest assured at all!
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Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.
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Old 05-14-2007, 01:30 AM #46
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Default Who invented Parkinson's Disease ?

Parkinson's Disease usually occurs when the activity of the dopaminergic neurons is insufficient.

There has always been the potential for dopaminergic neurons to be underactive, as there is for any biochemical function.

So Parkinson's Disease must have been around since human beings existed.

James Parkinson certainly didn't invent it.
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Old 01-26-2011, 02:13 PM #47
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bump bump bump
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Born in 1953, 1st symptoms and misdiagnosed as essential tremor in 1992. Dx with PD in 2000.
Currently (2011) taking 200/50 Sinemet CR 8 times a day + 10/100 Sinemet 3 times a day. Functional 90% of waking day but fragile. Failure at exercise but still trying. Constantly experimenting. Beta blocker and ACE inhibitor at present. Currently (01/2013) taking ldopa/carbadopa 200/50 CR six times a day + 10/100 form 3 times daily. Functional 90% of day. Update 04/2013: L/C 200/50 8x; Beta Blocker; ACE Inhib; Ginger; Turmeric; Creatine; Magnesium; Potassium. Doing well.
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