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 [log in to unmask]