The reason I am opting for a stroke is purely the history of head trauma. By
vascular stroke I assume you mean blood clot not a fatty embolism. Blood
clots can be semi transient in the body as long as they don't impede blood
flow too much whereas fatty embolisms are generally plaque type blockage or
fat type release from a bone injury usually difficult to remove.
Streptokinase therapy is a good anti clotting agent but must be done on a
docs say so of course and can be very dangerous if this isn't indicated. 
The imaging you have had to support this isn't stated so I don't know what
that involved. The best physiologic imaging is a nuclear medicine scan
whereby the blood flow to the brain is observed. Cat scanning is only useful
if the blockage can be seen visually whereas NM scanning lets the doc see
the actual hot /cold areas of the brain. If you haven't done ay NM scanning
then you can't rule out an embolic reason for the symptoms.
 For your information sinemet has a bout 20 minute response for PD, so in
the initial phases of PD there e is classic response time.
I assumed this was a car accident where contra coupe injury may be indicated
these also classic frontal and caudal lobe  injury cases. That would also
explain the symptoms. 
I hope this has been off assistance.
John Thomas
-----Original Message-----
From: Parkinson's Information Exchange Network
[mailto:[log in to unmask]] On Behalf Of Robert Ravel
Sent: Friday, November 27, 2009 11:40 PM
To: [log in to unmask]
Subject: Re: Treatments for atypical Parkinsons

 

 Thanks for your comments John.

I understand your point but we did in fact previously explore the
possibility of stroke. 

In my father's case the differential diagnosis was vascular stroke (not as a
result of head trauma), but the imaging did not really support it.

For the record, I am not suggesting that my father has idiopathic PD,
because this is clearly not the case. However he very likely could have a
condition sometimes referred to as post-traumatic parkinonism, which is part
of a cluster of consitions sometimes referred to as Parkinsons Plus,
Atypical Parkinsons, or Parkinsons Syndrome or simply Parkinsonism. 

These typically do not respond to levodopa. The reasoning behind this is
that whereas idiopathic PD spares the dopa receptors, Atypical PD conditions
do not spare the dopa receptors.

In any case I will run through differential diagnosis again when we see the
new neurologist in 2 weeks time, and see what he has to say.

Out of interest, we still have some recently purchased Sinimet tabs, and I
gave my father one pill two days ago. For about 24 hours there was zero
response. But the last two days, my father has been much much better, so
much so that he has had no NO freezing, no tremors in his hand, and he has
been able to get up off the couch by himself.

Now, I would love this to be a sign of responsiveness to levodopa, but like
you all know this condition is well known for good days and bad days, and in
all likelihood this is just 2 good days. Anyway, I just thought I would
mention it.

My focus however is to try anything that may help. Chances are nothing will
help, but I need to try for my own peace of mind.

And speaking of that, I just bought my father a whole body vibration unit.
Should be received within a  matter of days. There was been some positive
studies on HBV and Parkinsons, so I thought it is worth a try. I will keep
everyone posted if I notice anything that may indicate some response.

Robert

 

 

-----Original Message-----
From: john thomas <[log in to unmask]>
To: [log in to unmask]
Sent: Sat, Nov 28, 2009 4:41 am
Subject: Re: Treatments for atypical Parkinsons


Robert,
    I know this difficult to take or even understand, but I would
suggest your father is suffering from a stroke is far more likely than Pd.
Again whilst not meaning to be overly critical of the medical fraternity (
i.e. more often wrong than right ) neurological disorders are so varied with
their symptoms that it can be extremely frustrating when one is confronted
with a loved one's predicament. However sinemet reaction is the classic
response indicator for all idiopathic PD categories. Those cases that get no
response, are thus more likely, to be suffering from another cause. The fact
that your father has no response to sinemet means that he isn't idiopathic
PD. The fact that your father suffered a head injury would suggest a stroke
related cause for symptoms either lipoid or blood clot in cause.
I would urge you to seek the advice of a brain trauma medico before trying
self diagnosis.
Hope this helps .
John Thomas

-----Original Message-----
From: Parkinson's Information Exchange Network
[mailto:[log in to unmask]] On Behalf Of Robert Ravel
Sent: Friday, November 27, 2009 12:48 AM
To: [log in to unmask]
Subject: Treatments for atypical Parkinsons

 

Hi,

My name is Robert from Australia.

My father received significant head injuries in a road accident in 2002.

After rehabilitation he managed to slowly recover for a few years, but the
last 
5 years he has developed all the cardinal symptoms of Parkinsons disease,
and 
over 
the last 6 months in particular these symptoms have progressed to such a
stage 
that my father's quality of life has seriously diminished.

In 2005 we tried Sinimet but there was zero response.

It seems, like most cases of atypical Parkinsons, that the dopa receptors
were 
not spared.

I am desperately looking for treatments that may atleast modestly relive
some of 
my fathers symptoms. Even a 10% would make a huge difference for us.

(1) In one weeks time we will see our doctor for botox injections. At this
stage 
I suspect that the injections will be in the calf muscles, but if anyone can

suggest sites of injection to assist with dystonia, I would really
appreciate 
it.

(2) A week later we will be seeing a neurologist for trial of
pharmacological 
medications to hopefully assist. I know most neurologist would not even
bother, 
given the low response rate for atypical Parkinsons, but I have my fingers 
crossed.

I have read of some success with atypical parkins and the Dopamine receptor 
agonist called bromocriptine, and am hopeful that my father can trial this.

I have also read about the transdermal administration of rotigotine, and
would 
be asking about this too.

I am however looking for any other pharmacological suggestions for atypical 
parkinsons, with some science behind them, to suggest to the neurologist as
a 
trial.

Can anyone help me?

Thanks

Robert


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