IS IT PD?
The purpose of this communication is to raise again the question among PWP
and care-givers: is it PD?
I was diagnosed with PD in Feb., 1996. I had gone to my primary physician
(pp) with a series of medical problems: depression, slow movement, memory
problems, and gait instability. After some motor response tests, my pp sent
me to a neurologist for a more extensive evaluation. At the end of the
session the neuro said I may have PD. He prescribed Sinemet. He said that
if my symptoms improved after a few weeks on Sinemet, then I have PD. He
put me on Sinemet, 25/100, half pill 3x/day. My symptoms improved and
I therefore had PD according to the neuro.
My condition deteriorated to the point that, by mid-July, my voice was a
high pitched, soft, monotone. I could not remember anything. I mean, if I
went to the store, not only could I not remember where I parked, I could not
remember if I drove. I began seeing a psychotherapist to baseline the memory
problems. After memory testing, the therapist got the neuro to have me get
an MRI. The MRI conclusively showed I had hydrocephalus, a rare condition
the symptoms of which mimic PD exactly. But PD was not ruled out by the
neuro. He felt I could have both PD and hydrocephalus
I was immediately scheduled for a shunt implant to relieve the fluid
pressure on the brain. When I reviewed my case history with the
neurosurgeon, esp. the effect of Sinemet, he said that since no one knows
exactly how Sinemet works, the fact that it might effect the symptoms of
hydrocephalus is not surprising, thus putting into doubt the so called "gold
standard" proof of PD.
I had the operation on Aug. 1, 1996. Within a month my voice had returned
to normal. As the damage caused by the hydrocephalus abated, other symptoms
disappeared, leaving what may be permanent memory damage. This is typical
of hydrocephalus. Finally, a week ago, my new neuro took me off Sinemet.
No symptoms of PD reappeared.
Therefore he has concluded that I do not have PD.
I have a few comments about my involvement with PD. Theses are:
1. Get a second opinion. I believe the statistics indicate about 25% of the
cases are misdiagnosed.
2. Do not believe one person or one dx. Question all conclusions. Develop
expertise in your condition. Since there is no one with a greater interest
in your condition than you, you must manage it. I found Medline on
the Net as the source of information. Explore all other conditions
which can mimic PD.
3. Have an MRI. It can eliminate some possibilities, such as a tumor or
hydrocephalus.
4. Have a personal, medical advocate to help through the tough
times, like my wife.
