Once again, Judith supplies a cutting-edge report on our disease. Were it not for her, at least one among us would know a whole lot less. But this one causes me a few problems, all stemming from the following statement: "About 7 million people around the world have Parkinson's disease, which usually strikes after age 60, causing progressive tremor, muscle rigidity and other movement problems." I can personally attest to the tremor, and the muscle rigidity, and most of my movements are definitely problems! - but where did these guys come up with a PD population of 7 million "around the world?" =46or starters, if up to 1.5 million of us have it in the U. S. of A., with = a mere 290 million people, how can there be only 7 million with the disease in a world of about 6 billion people? I'll not even bother to compute the ratios. Nonetheless, printed in such a prestigious journal, these are terribly frightening numbers. Frightening because those in power, political and medical, see them and believe and rely on them - or pretend to do so. =46rightening, too, because you know that this release was reviewed for syntax and substance before it was printed, and yet it was released, in a prestigious journal. And then the real flight of whimsy: "Which usually strikes after age 60." All these years I had thought that the oft-repeated average of 57 AT DIAGNOSIS was far too old - now they tell me it STRIKES "after age 60?" Wow! I must've been a preemie! I was diagnosed at 57, but I now know that the disease had "struck" at least seven years previous. The symptoms were there, I just didn't recognize them as Parkinson's. Nor did the respected geriatrics doctor I played tennis with regularly who, when shaking my cold hand after our match over a period of a number of winters commented, "You might take niacin to warm up that hand." I was 52 to 55 then. Parkinson's had struck, undiagnosed, in clinic or on co= urt. Is there empirical data to support the "7 million around the world?" The "strikes after age 60?" Am I an aberration? Are you? And if we are not, and those numbers are simply wrong, who is going to print an "aberration clarification?" Bob Dolezal At 11:23 PM 10/14/98, judith richards wrote: >Brain surgery helps severe Parkinson's > >NEW YORK, Oct 14, 1998 (Reuters) -- Patients severely disabled by >Parkinson's disease can reduce or even eliminate their need >for medication by undergoing an operation in which implanted electrodes >are used to stimulate the subthalamic nucleus, a region >of the brain that controls movement. > >In a new study on 24 patients, 20 followed for a year had a 60% >improvement in their ability to perform routine activities, and >their average dose of drugs was cut in half in the year after the >procedure, according to a report in the October 15th issue of >The New England Journal of Medicine. > >The other four patients were not included in the study for several >reasons, including complications stemming from the procedure >such as infection requiring removal of the electrodes. One patient who >had a brain hemorrhage during surgery, causing long term >paralysis and loss of speech. > >However, 4 of the 20 patients who underwent subthalamic nucleus >stimulation (STN) have been able to eliminate their need for >levodopa, the most common drug used to treat Parkinson's disease. >Levodopa, or L-dopa, eventually loses its ability to control >the symptoms of Parkinson's disease and can cause uncontrollable >movements on its own, known as dyskinesia. About 7 million >people around the world have Parkinson's disease, which usually strikes >after age 60, causing progressive tremor, muscle >rigidity and other movement problems. > >Eight of the patients had short term mental difficulties, including >confusion, hallucination and disorientation after the surgery > >Lead investigator Dr. Pierre Pollak of Joseph Fourier University of >Grenoble and the University Hospital of Grenoble in France >also presented the new data at the 5th International Congress of >Movement Disorders in New York. > >``The technique is ``not for everyone,'' Pollack said. There is a 2% to >5% risk of bleeding during the neurosurgery, and only the >most disabled patients are eligible. The ideal candidate is a younger >patient -- average age in this study was 55 at the time of >surgery -- with advanced disease complicated by dyskinesias and motor >fluctuations. > >Overall, only 15% of all Parkinson's patients ``will be clearly >improved'' with subthalamic nucleus stimulation, he said. > >But unlike levodopa, STN appears to continue working over time. No >tolerance to stimulation appears to develop and five >patients who have been followed the longest -- 5 years -- have had a >stable improvement in symptoms, he said. Of the 70 >patients treated with the technique, two have had deterioration in >mental ability. However, both were in early stages of dementia >at the time of surgery, Pollak said, but he acknowledged that there was >a ``speeding of decline associated with surgery.'' > >SOURCE: The New England Journal of Medicine 1998;339:1105-1111. >-- >Judith Richards, London, Ontario, Canada ><[log in to unmask]> > ^^^ > \ / > \ | / Today=92s Research > \\ | // ...Tomorrow=92s Cure > \ | / > \|/ > ```````