"Following Muhammad Ali’s death, there has been persistent dialogue about the degree to which Parkinson disease vs repetitive boxing-related head trauma contributed to his progressive motor and cognitive impairments."
The authors go on to say, "Muhammad Ali’s disease course, from his late 30s until his death at age 74 years, was chronic and progressive. He manifested fatigue, hypophonia, bradykinesia, and a masked face, as well as many of the visible motor symptoms of Parkinson disease. He was clearly responsive to levodopa, as documented in his several examinations in the early 1980s, a feature usually not present following traumatic brain injury."
Where this is leading is, "A 34-year chronic progressive presentation with asymmetric levodopa responsive resting tremor, accompanied by other classical features, provides strong evidence for a diagnosis of idiopathic Parkinson disease. In contrast, posttraumatic tremor is commonly transitory, and manifests as a postural and/or kinetic tremor. In addition, posttraumatic tremor is not accompanied by progressive cogwheel rigidity and bradykinesia, both observed in Ali. Head trauma is a known risk factor for the later onset of idiopathic Parkinson disease; however, a causative association in the Ali case cannot be determined."
In conclusion, "Many patients with young-onset idiopathic Parkinson disease presenting like Muhammad Ali have been misdiagnosed or have experienced a delayed diagnosis. The greater emphasis of the public on his obvious boxing-related sequalae frequently overshadowed the diagnosis of an early-onset case of Parkinson disease."
"The Muhammad Ali case reinforces the dangers of the press, public, and health care professionals in speculating on medical diagnoses."
My mom was diagnosed with PD at 52 years old. She was having neurological symptoms (freezing gait and resting tremor) and quietly seeing doctors who didn't give her a diagnosis or refer her to neurology. She and her husband were looking at a lake property to buy and the seller said, I know what you have - It's parkinson's disease (one of their family members had it). There is no history of PD in my family before my mother. I went with my mom to Struthers Parkinson's Institute in MN where her PD was diagnosed in 1995. My mom had been in a car accident in 1981, she had whiplash and a head injury and later surgery on her neck. My mom concluded that her Parkinson's was caused from her car accident because Muhammad Ali had PD and he was a boxer! My mom stopped investigating causation at that point.
I believed a doctor told her the head injury caused the PD and never worried about getting a neurological disease myself.
Fast forward 20 years, in early 2015 I'm developing neurological symptoms that I think might be PD. It's the only neurological disease I've had experience with. ALS was not on my radar until mid-2018.
I tried to get an appointment at Mayo Clinic in Rochester MN, they were booked until April 2016, by now it's clear that something is very wrong neurologically. I had a physical and flunked the sobriety test (tandem walk) I blamed it on my new shoes. I was referred to Neurology and ENT for my smell loss. Looking back my reflexes we're brisk too, but I didn't know what that meant.
I had major surgery at Mayo in 2010 and was an existing patient. A functional medicine doc told me a couple years ago that the surgeries at Mayo set me up for my ALS diagnosis [that is temporally related to my agricultural chemical poisoning in 2014.]
The car accident and surgery my mom had was a contributing factor in her loss of cognitive reserve but it was not temporally related to her acquired PD because it had been more than 10 years between the car accident and the diagnosis. What is temporally related to my mom's parkinson's diagnosis is her occupation as a beautician and long-term exposure to ammonia from permanent wave solution and hair dye. And exposure to pesticides in her Florida home from 1985-1988 when her husband (low IQ) decided to DIY pest control inside the house and regularly sprayed the baseboards for roaches. I was visiting with my two children (toddler and infant) when he did this 🤬
With idiopathic PD it's hard to identify a single event, it's more likely a combination of contributing factors. We aren't educated about this and it's easy to get sidetracked on causation.
Muhammad Ali's is a cautionary story. We don't know what his other contributing factors are.
I'm living proof of cause and effect and my story is important to tell.
“A functional medicine doc told me a couple years ago that the surgeries at Mayo set me up for my ALS diagnosis [that is temporally related to my agricultural chemical poisoning in 2014.]”
Anesthesia is toxic to the brain. Our cognitive reserves buffer the effects, but gets depleted over time.
Edit: there are accounts of people getting diagnosed with ALS shortly after surgery.
I know first hand from recent lithotripsy surgeries for kidney stones, that anesthesia has progressed my ALS and very recently increased my myoclonic seizures. In one instance I was given succinylcholine and went into cardiac arrest.
Surgery can no longer be the default treatment. I'm so tired of the medical system. They've done nothing to support me and I'm headed towards kidney failure. I'm going to give naturopathic medicine a try, anything is better than the status quo.
my 2 cents… diagnosed in 2015 at age 62, 7 months aFter suicide of my life partner (we were together for over 33 years). Illegible handwriting was my 1st symptom, I have bradyk, severe fatigue,apathy,depression,swallowing,speech and balance issues, rigidity, poor fine motor skills. I trained like an athlete and professional dancer prior to diagnosis. There is no pd history in my family. More than one neurologist Has said they felt my pd was brought on by emotional trauma. I believe this to be true. I think we all may have a predisposition to certain diseases and stress or severe physical or emotional trauma can trigger the onset of disease in us. I clearly remember when my life partner was having a panic attack, I had a meltdown and couldn’t stop crying. I felt something “snap” in the back of my head (no pain) and did not think again about that “snap” until I was diagnosed with pd.
Bottom line for me, whether my pd was triggered by Steve’s suicide or not, it doesn’t really matter. What matters is how i deal with this insidious disease and how I can maintain some semblance of a good quality of life.
i am so sorry about your sister..... no signs that i can recall for me, I was very healthy . when i mentioned to my PCP at annual chekup about my handwriting , she told me to see a neurologist
Thank you, and I'm sorry about your partner too. These trauma's from complicated deaths become complicated grief. You don't just bounce back. Making a good life for yourself is a great way to honor your life partner. Have you looked into Ketamine treatment?
I remember reading that Ali was a master at 'slipping punches' meaning he could move his head out of the way of incoming punches and not suffer brain damage.
I was pretty young then but didn't he brag about having a pretty face? Can't get knocked out if punches don't land on the head. I wonder how many times Ali was dazed or knocked unconscious during his career. This medical review says they can't correlate his boxing career with his PD.
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Practice Parameter: Neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review)
ACTIVE-ASSISTED CYCLING improves tremor and bradykinesia in Parkinson's disease.
Muhammad Ali hospitalized with respiratory issues that may be more serious 
