 |
 |
You wrote: > >The man with benign essential tremor (familial tremor) is 76 years old and >depressed and full of anxiety. I would think it a good idea to try a mild >tranquilizer first before saying he has PD as well. Caution: Older people >often respond badly to tranquilizers and antidepressants and can become even >more anxious and >"nervous" so have to be careful with these drugs. Even the old bromide of >trying a course of Sinemet to rule out or in PD can backfire in older >depressed people so one needs to cautiously and slowly introduce Sinemet over >a period of days. > "They" say one needs three PD symptoms - for instance, tremor, rigidity >and slowness - to earn a diagnosis of PD. I've seen depressed older persons >without PD look like that. >Barbara Yacos ><[log in to unmask]> > > Barbara has a good idea, but please do not forget a good neurological workup. The symptoms could be due to another neurological condition. At minimum, the patient should have a CT scan to rule out "normal pressure hydrocephalus", which can also cause Parkinsonian-like symptoms. Best, Bob -- ******************************************************** Robert A. Fink, M. D., F.A.C.S. Phone: 510-849-2555 Neurological Surgery FAX: 510-849-2557 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 USA E-Mail: [log in to unmask] CompuServe: 72303,3442 America Online: BobFink "Ex Tristitia Virtus" ********************************************************