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RTK.NET Mail 178322 Jul 30 18:06:38 1996 The question of what would happen when someone without PD took Sinemet reminded me of something the Amgen researcher who addressed the PAN forum said. While it's certainly quite plausible that someone without PD who takes Sinemet would have little trouble because they simply stop making dopamine in the interim, some researchers think that the dopaminergic cells are able to regulate the release of the dopamine already present in the brain at any given time. If I understood him correctly, I think this means some people can hold onto excess dopamine and release it later. Autopsies of Parkinson's patients at various stages have shown that the approx. 80% of the dopamine producing cells people have lost around the time of diagnosis have not actually died but have ceased to function. At later stages, these cells do actually die, and one theory about problems such as dyskinesia and strong OFF times is that these cells still serve to help regulate dompamine levels until they actually die off. One of the most hopeful things about the upcoming GDNF (glial-cell-line-derived nerve growth factor) trials is that in addition to improving the function of existing cells and preventing further cell death, they might restore the function of these non-functioning cells that have not yet died. Regarding the confirmation of diagnosis with typical or atypical PD, there is the prohibitively expensive PET scan. Does anyone know if the alternative scan (sorry I forget the name) there have been recent papers on will be reasonably inexpensive and available soon? Will it distinguish between PD and certain types of PD plus, like Shy Dragers? Regarding the original poster's questions about her father's visual problems: I think the usual visual problems with PD are reduced contrast sensitivity which manifests most often as a difficulty focusing and adjusting to changing lighting. Scotoma, where visual acuity is lessened in one area of your visual field or you see shadows or colored patches, is usually, I think, most apparent in the center of the field but could also occur in another part of the field. But I get that effect from migraine auras, and it would not make me miss the food on one part of my plate even though the usual location of mine is similar to your father's. He really needs to be evaluated specifically for this difficulty, because it may not be his vision but more a type of aphasia. Did your father have an MRI as part of his diagnosis or at least a CT scan? Often only younger patients are given these tests before diagnosis, but in an atypical case I think it's even more important to rule out a stroke or any type of tumor. Good luck, distant caregiving isn't easy, especially when no one can agree on what to believe and who to trust. Sherri [log in to unmask]