I just attended a seminar at Which Dr Montgomery from
Cleveland Clinic Foundation and Dr Sherman from University of Arizona were the
featured speakers.
I am a new Parkie (diagnosed 1 month ago) and his
recommendation for newly diagnosed Parkies is to start Selegine, not for symptom
relief, but for the possible slowing of the progress of the disease. When
symptoms interfere with the quality of life and you desire to have them
controlled begin with a dopamine agonist such as Requip or Mirapex. They
may equal the effectiveness of levodopa for one to three years. When their
effectiveness begins to wear off then move to levodopa. He did not recommend
taking Sinemet to confirm diagnosis.
He was very negative concerning Thalamotomy surgery, and feels
Pallidotomy surgery should be used only in special situations and that Deep
Brain Stimulation (DPS) surgery is the way to go. This surgery (if I
understood correctly) has not been approved in the US but is being done, and it
is not considered to be experimental. Over 100 such surgeries have been
done in Cinncinnati and medicare has approved them.