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12/05/2001 - Updated 04:38 PM ET USA Today Debra Jo Rupp shares hope for Parkinson's disease By W. Reed Moran, Spotlight Health With medical adviser Stephen A. Shoop, M.D. Debra Jo Rupp says people with Parkinson's need lots of help from their friends and loved ones. As the mother in the Fox hit That 70's Show, actress Debra Jo Rupp knows how to draw humor from her often-difficult family. But finding the laughter in crisis is also what Rupp does in real life. That's because her mother is battling Parkinson's disease (PD). "Several years ago, my mother started suffering from symptoms of what turned out to be Parkinson's disease," says Rupp. "Part of what was so frustrating and frightening was that her condition was so hard to diagnose. Rupp says that mother, Margaret, who is now 72, began falling repeatedly, had minor traffic accidents, and eventually began struggling for words. "When we brought her to a doctor, we initially thought she had experienced a stroke," says Rupp. But after being referred to a specialist through Rupp's friend and fellow actress Lisa Kudrow, the proper diagnosis was finally determined. Rupp's mother was diagnosed with cortical basal ganglionic degeneration, a rare disorder characterized by Parkinson's disease and cortical degeneration. Because the symptoms were already severe and progressed rapidly, Rupp's mother is now in a nursing home. "At this point, my mother can't talk, walk, or use her hands ... but the miracle is that she is cogent and can still laugh," says Rupp. And it is the balm of laughter that has buoyed the spirits of the family members as well. "People ask, how do we all get through this experience day by day?," says Rupp. "The answer is we all understand the basic absurdity of the situation, and laughter's a way of communication that can go deeper than words." Rupp says that adversity has also brought her family closer. "We simply found we had to readjust our expectations, but we were all in this together," says Rupp. And while Rupp has accepted the reality of her mother's late-stage symptoms, she is an ardent advocate of hope for others. "Parkinson's is a condition that's seen enormous advances in treatment. Early diagnosis allows patients and their families to enjoy a greatly enhanced quality of life." Getting the facts Parkinson's is a chronic, slowly progressive neurological condition that affects a small area of cells in the middle brain known as the substantia nigra. Gradual degeneration of these cells causes a reduction in the vital chemical dopamine. This decrease in dopamine can produce one or more of the classic signs of PD: Resting tremor on one side of the body Generalized slowness of movement (bradykinesia) Stiffness of limbs (rigidity), and Gait or balance problems According to the National Parkinson Foundation (NPF), up to 1.5 million Americans are affected by PD, more than those suffering from multiple sclerosis and muscular dystrophy combined. PD affects approximately one out of every 100 persons over 60 in the USA. The cause of PD remains a mystery. It is not contagious, and at present there is no conclusive research that identifies an actual gene linked to Idiopathic Parkinson's Disease — the most common form of PD. Since there is no definitive lab test or brain scan to verify the clinical diagnosis of PD, the NPF strongly recommends that patients seek a verification of this condition from a board-certified neurologist who specializes in movement disorders. While there is as yet no known cure or prevention for PD, progressive treatments allow many patients to maintain a high level of function throughout their lifetimes. But the NPF emphasizes it would be a mistake for newly diagnosed patients to drift from doctor to doctor looking for a "magic bullet" or miracle drug to completely eliminate all symptoms of PD. Living well with PD Many early PD symptoms can be controlled with currently available medications such as Sinemet. The best results are obtained in the first few years. However, with long-term use some patients notice a shorter duration of action from each dose. Other drugs, called dopamine agonists, are often used in conjunction with Sinemet to prolong its duration and action. Surgical procedures such as thalamotomy for tremor, and pallidotomy for overall disability, have also been shown to enhance the quality of life for many PD patients. Most physicians agree that brain surgery is a reasonable option only for patients who are no longer responsive to optimal medication management. One of the latest advances in neurosurgery is deep brain stimulation (DBS), wherein an electrode is planted deep within the brain and controlled by the patient with an on/off magnetic device. Dr. Michael Dogali, professor of neurosurgery at the University of Southern California, is a pioneer in the development of a new procedure called simultaneous bilateral deep brain stimulation. "The advantage of bilateral DBS is that we are able to address many Parkinson's symptoms on both sides of the body with one surgery," says Dogali. Thanks to an exemption from the FDA, Dogali and his colleagues working at Good Samaritan Hospital in Los Angeles are one of few surgical teams in the nation currently able to provide bilateral DBS. "No other therapy has shown to dramatically suppress symptoms of advanced Parkinson's," says Dogali. Recent results indicate that bilateral DBS can reduce rigidity, slowness or absence of movement by as much as 60% and reduce tremors by more than 90%." Dogali reports that unlike other surgical procedures such as pallidotomy, DBS does not destroy brain tissue, and the electrical stimulation can be adjusted to a patient's changing needs. "There is also clinical evidence that early intervention with DBS can be neuroprotective," says Dogali. "It has been shown to actually shield brain tissue and prevent the disease from progressing." Dogali emphasizes that while a cure for PD is at least 10 years away, bilateral DBS can make a huge difference in the lives of people currently dealing with the advanced stages of the illness. Meanwhile PD patients and their families cope the best they can, one day at a time. "It is what it is," says Rupp. "For now, we can't stop it, but we can always seek the best medical advice and give much-needed emotional support to our loved ones." And as Rupp reminds us, when times are toughest, don't forget to laugh. SOURCE: USA TODAY http://www.usatoday.com/news/health/spotlight/2001-12-05-rupp-life.htm * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn