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Hi Barb,

  I have a little correlary/correction to make on your explanation of the
various types, as classified by Dr. Iacono.  Type A patients are the individuals
with significant Tremor, while Type B Parkinson's is classified as the akinetic
type (stiff, as you described it).  I am also not aware of Type C or D, but
there is a "Tremor-Dominant Type" as well as the Parkinson's Plus which you're
aware of.  By the way, this information HAS been published in several journals
and is actually on one of the articles at Dr. Iacono's website at the following
address:  http://www.pallidotomy.com/papers/neurosurgery/index.html

Fatta

Date:    Tue, 11 Nov 1997 04:34:45 -0500
From:    Barbara Mallut <[log in to unmask]>
Subject: To K-F Etzold
YIKES!  K-F, I've tried to respond to your email address several times and the
message keeps getting returned to me by the auto-postmaster.  Whoever said
that "things" would be SO much easier when everyone got used to using
computers was WRONG! <grin>
I hope you get this via the List 'cause the only other way to send it is via
snail mail - and ...uhhhhh.... I don't think I remember how to use THAT after
emailing for so many years! <smile>
My original response to you...
K-F...
Oh DARN!!   I knew this was gonna happen when I posted my comment about their
being several types of PD.   Nope... I have no references whatsoever on this
topic - technical or otherwise.  The comment was born out of my own personal
experience with  the "ABCD" rating at Loma Linda University Medical Center
when Dr. Iacono classified my PD prior to my pallidotomy 3 years ago.
The rating, which ISN'T the "Hoehn & Yahr rating" (that defines the level of
functionality the person with PD is at as well as defining the stage of the
disease they are in and is a "one-thru-five rating), just had those four
options, A thru D, with A being only stiff, B being only tremor, and since C &
D didn't involve my symptoms at all, Dr .Iacono never went into what they
were.  It further reinforced the "A-thru-D rating" by being broken down with
the PD patient responding to a list of questions, requiring
"always/sometimes/never" answers for both the right and left sides of the
body.  These answers enabled the MD to further pinpoint the symptoms of each
PD patient.
I was an A-B type - Mostly very stiff with very little tremor, and whatever
tremor I had wasn't visible.
Wish I had more information to offer ya, but that really IS all I know about
this rating scale.   At the time I saw Dr. Iacono, I felt SO rotten, and was
SO glad to FINALLY see a movement disorder SPECIALIST (heck, I didn't even
know there was such a thing till then!) - after so many years of my former
neuro telling me how WELL I was doing when I was on a slow but steady downhill
slide, that I could have cared less what I was classified on any rating scale
Ohh... and before I forget, I'm pleased ya enjoy my comments.  It's a nice
feeling to be appreciated.
Barb Mallut
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