I'm confused

[TheresaCurley]

What are the differences between Parkinson's Disease and Parkinsonism? How can they identify one from the other and is one less progressive than the other?

[park_bear]

Parkinsonism is a condition that results in motor symptoms similar to Parkinson's, and is usually the result of a toxic substance injuring the dopamine producing neurons in the brain. Parkinson's does the same thing, but due to an impairment of the processing of the protein alpha-synuclein. Parkinson's is progressive, whereas Parkinsonism can be sudden and dramatic, as in the case of the drug users who got the bad drug now known as MPTP.

[TheresaCurley in reply to park_bear]

How can the doctors tell the difference between Parkinson and Pakinsonism from a DatScan, if both are the results of depleted dopamine?

[Enidah in reply to TheresaCurley]

If you go into the Michael J fox website and check out the webinar they have once a month, I think the last one was on this very subject. The webinars are usually very good and informative.

[TheresaCurley in reply to Enidah]

I will do that today. Thank you.

[999---666 in reply to park_bear]

alpha-synucliem, is that the precursor to dopamine? and is it possible that it is not being processed because of a problem with the liver?

[TheresaCurley in reply to 999---666]

HUH?

[999---666 in reply to TheresaCurley]

your body converts your food into substances your brain can use. they are called precursors, precursors to dopamine.

your food might be converted into several different substances before it becomes dopamine for your neurons. refined, in a sense.

[TheresaCurley in reply to 999---666]

Now I understand what you are saying. I don't know if my liver has a problem. I get a blood test every 3 months and I'm always told my liver is fine.

[999---666 in reply to TheresaCurley]

Theresa, was surfing and came across something about OPC's. has bearing on diabetis II, which they claim is an autoimmune problem not a metabolic problem.

[BillDavid]

HAVE LOOKED INTO RECENTLY, NOTES FOLLOW

First, a consideration in diagnosis…..described by Alex Kerten.

Parkinson’s Disease or Parkinsonism……a Distinction

The Five Stages of PD

Stage 1 – (known as Parkinsonism) – person has some symptoms, but these don’t have to develop or get worst. .

Stage 2 - symptoms much more noticeable – stiffness, freezing, tremors and trembling,

Gait is stiff. The progress from Stage 1 to 2 can take months or even years – and if you’ve been able to change your script and communicate between mind and body, it never has to get there.

Stages 3,4, and 5. These stages of PD mark the major turning point in disease progression. Daily tasks become difficult and behavior unmistakably Parkinsonian.

Said in other words…..

In the course of Parkinson’s Disease, Diagnosis, in itself, is a major Concern. (CWH)

The onset of Parkinson’s is gradual. This is experienced as a variable set of Symptoms such as tremor, lack of arm movement during Gait. or slowing of movement.

The Disease is defined as having Five Stages.

Initially, in the first stage, it is unclear whether Parkinson’s Disease itself or Parkinsonism Syndrome is manifest. Even though Parkinsonism is less prevalent, Differential Diagnosis between Parkinsonism Syndrome and Parkinson’s Disease becomes an issue as initial manifestations are similar. The operational question being, which of the two do the observed symptoms represent? ..

The manner of observation also plays a role. Initially, diagnosis involves recognizing the expression of the various symptoms..Com[pared to Parkinson’s Disease, Parkinsonism, is much less responsive to treatment by LDopa. To differentiate, Patients are often given LDopa, whose effect over time is used to differentiate between the two.. .

Parkinsonism Definition (CWH)

Parkinsonism

is a general term that refers to a group of neurological disorders that cause movement problems similar to those seen in Parkinson’s disease, such as tremors, slow movement and stiffness. Under the category of Parkinsonism there are a number of disorders, some of which have yet to be clearly defined or named. Early in the disease process, it is often hard to know whether a person has idiopathic (meaning “of unknown origins”), Parkinson’s disease or a syndrome that mimics it. Parkinsonism, is also known as atypical Parkinson’s disease or Parkinson’s plus.

They tend to progress more rapidly than Parkinson’s, present with additional symptoms such as early falling, dementia or hallucinations, and do not respond to or respond only for a short time to, levodopa therapy.

Diagnosis Uncertainty

There is no definitive test to detect Parkinson’s disease or Parkinsonism. For diagnosis, doctors take a thorough medical history and may request a number of movement tests. Because of the observational nature of the diagnosis, Parkinson’s can sometimes be confused with Parkinsonism, and the diagnosis may need to be revised over time based on speed of disease progression, response to medications and other factors.

All the Parkinsonisms have a loss of dopamine, so a DatScan cannot be used to differentiate between them and idiopathic Parkinson’s disease.

Diagnose PD Using Medication (usually Levodopa).

 Problem, there is No Marker for Parkinsonism or Parkinson’s Disease.

 By the time medication is useful for diagnosis., PD has already progressed

beyond Stage1. Usually Levodopa is used for diagnosis.

In turn treatment becomes focused on Levodopa. Which initially, early in the course ot the disease (Stage 2), is very effective.

However, on going treatment with larger amounts, Levodopa tends to be less effective. (Stage 3)

Typically leads to Addiction…and resulting Focus on Side Effects….Rapid

On, Off Cycling, Dystonia, Dyskinesia.

Wellness (exercise, physical therapy) would be better place for initial focus and

assessment. Would provide opportunity to delay the onset of disabling symptoms. .

[TheresaCurley in reply to BillDavid]

This has been very helpful. Thank you.

[p-oui]

Theresa, As I understand it, 1 in 200 adults will contract PD but diagnosis will often be delayed because it is such a complex disease that I have begun to think of it as a syndrome as it demonstrates with a diverse manifestation of symptoms and you may present with symptoms entirely different than the symptoms I display. As someone new to PD I find it difficult to understand. Then to make it more difficult, there is some kind of distinction between PD and Parkinsonism. It apppears to me medical professionals also have difficulty distinguishing this. Further I am not sure what changes in the treatment approach from PD to Parkinsonism. For example, if you present with PD symptoms, whether it is PD or not, you likely have a depletion of dopamine and you may be given a pill, levadopa, and perhaps you respond whether it is PD or whether it is parkinsonism. What have you really learned? This is why I am focusing on what I can accomplish in terms of feeling better through exercise and other "wellness" measures. I work out ten hours a week now and while I am not sure I have the right mix of exercise down (working on it) I am convinced that exercise is having an impact on my symptoms and how well I feel generally. If I can do this without levadopa - then I can take charge of managing my health and my PD (or Parkinsonism). To me, right now, that is the most important thing. Thanks again for your post -- these are great questions and I wish I knew answers but I appreciate also you sharing your insights along the way. Keep us posted!