Once again, Judith supplies a cutting-edge report on our disease.  Were it
not for her, at least one among us would know a whole lot less.

But this one causes me a few problems, all stemming from the following
statement:  "About 7 million people around the world have Parkinson's
disease, which usually strikes after age 60, causing progressive tremor,
muscle rigidity and other movement problems."

I can personally attest to the tremor, and the muscle rigidity, and most of
my movements are definitely problems! - but where did these guys come up
with a PD population of 7 million "around the world?"

=46or starters, if up to 1.5 million of us have it in the U. S. of A., with =
a
mere 290 million people, how can there be only 7 million with the disease
in a world of about 6 billion people?  I'll not even bother to compute the
ratios.

Nonetheless, printed in such a prestigious journal, these are terribly
frightening numbers. Frightening because those in power, political and
medical, see them and believe and rely on them - or pretend to do so.

=46rightening, too, because you know that this release was reviewed for
syntax and substance before it was printed, and yet it was released, in a
prestigious journal.

And then the real flight of whimsy:  "Which usually strikes after age 60."

All these years I had thought that the oft-repeated average of 57 AT
DIAGNOSIS was far too old - now they tell me it STRIKES "after age 60?"
Wow!  I must've been a preemie!  I was diagnosed at 57, but I now know that
the disease had "struck" at least seven years previous.  The symptoms were
there, I just didn't recognize them as Parkinson's.  Nor did the respected
geriatrics doctor I played tennis with regularly who, when shaking my cold
hand after our match over a  period of a number of winters commented, "You
might take niacin to warm up that hand."

I was 52 to 55 then. Parkinson's had struck, undiagnosed, in clinic or on co=
urt.

Is there  empirical data to support the "7 million around the world?"  The
"strikes after age 60?"  Am I an aberration?  Are you?  And if we are not,
and  those numbers are simply wrong, who is going to print an "aberration
clarification?"

                                Bob Dolezal

At 11:23 PM 10/14/98, judith richards wrote:
>Brain surgery helps severe Parkinson's
>
>NEW YORK, Oct 14, 1998 (Reuters) -- Patients severely disabled by
>Parkinson's disease can reduce or even eliminate their need
>for medication by undergoing an operation in which implanted electrodes
>are used to stimulate the subthalamic nucleus, a region
>of the brain that controls movement.
>
>In a new study on 24 patients, 20 followed for a year had a 60%
>improvement in their ability to perform routine activities, and
>their average dose of drugs was cut in half in the year after the
>procedure, according to a report in the October 15th issue of
>The New England Journal of Medicine.
>
>The other four patients were not included in the study for several
>reasons, including complications stemming from the procedure
>such as infection requiring removal of the electrodes. One patient who
>had a brain hemorrhage during surgery, causing long term
>paralysis and loss of speech.
>
>However, 4 of the 20 patients who underwent subthalamic nucleus
>stimulation (STN) have been able to eliminate their need for
>levodopa, the most common drug used to treat Parkinson's disease.
>Levodopa, or L-dopa, eventually loses its ability to control
>the symptoms of Parkinson's disease and can cause uncontrollable
>movements on its own, known as dyskinesia. About 7 million
>people around the world have Parkinson's disease, which usually strikes
>after age 60, causing progressive tremor, muscle
>rigidity and other movement problems.
>
>Eight of the patients had short term mental difficulties, including
>confusion, hallucination and disorientation after the surgery
>
>Lead investigator Dr. Pierre Pollak of Joseph Fourier University of
>Grenoble and the University Hospital of Grenoble in France
>also presented the new data at the 5th International Congress of
>Movement Disorders in New York.
>
>``The technique is ``not for everyone,'' Pollack said. There is a 2% to
>5% risk of bleeding during the neurosurgery, and only the
>most disabled patients are eligible. The ideal candidate is a younger
>patient -- average age in this study was 55 at the time of
>surgery -- with advanced disease complicated by dyskinesias and motor
>fluctuations.
>
>Overall, only 15% of all Parkinson's patients ``will be clearly
>improved'' with subthalamic nucleus stimulation, he said.
>
>But unlike levodopa, STN appears to continue working over time. No
>tolerance to stimulation appears to develop and five
>patients who have been followed the longest -- 5 years -- have had a
>stable improvement in symptoms, he said. Of the 70
>patients treated with the technique, two have had deterioration in
>mental ability. However, both were in early stages of dementia
>at the time of surgery, Pollak said, but he acknowledged that there was
>a ``speeding of decline associated with surgery.''
>
>SOURCE: The New England Journal of Medicine 1998;339:1105-1111.
>--
>Judith Richards, London, Ontario, Canada
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