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PK or MS?


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#1 Reza Fatemi

Reza Fatemi

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Posted 31 May 2011 - 04:18 PM

Patience’s Symptoms and history in chronological order from 7 years ago till now:

1) The first sign of any abnormalities appeared at the age of 13, during a sport activity in the school yard, when my head started to feel hot, with short periods of headaches. I was then sent home and shortly after, my face became hot, and the left side of my body became numb and weak.

2) The MRI results indicated blood clot in / around the brain area, however all other medical tests came out as normal, and although within 2 to 3 days, I felt almost recovered, I was still feeling a slight weakness in my arms and feed.

3) Three months later, I started to feel extreme weakness on the left side of my body and lost control of normal functions and mobility, to the point that I could not hold a spoon or grab anything. This went on for three days at the end of which, I could not take a step forward without dragging my feet.

4) MRI results indicated blood clot in my brain and once again, all other medical tests came out with normal results. I was then put on “FOLIC ACID” and was told to stop any exercise and sport activity.

5) Three months later, I started having issues with my vision as I could not see long distance. I was rushed to the hospital and the doctors performed / ordered the following medical tests which all came out normal:
a. MRI
b. Echocardiogram
c. Ultrasound exams of my neck and lung arteries / veins.
d. Spinal fluid analysis

6) I was released from the hospital the next day and was put on “FOLIC ACID” and although I started feeling better, I still felt weakness in my legs and feet and started to experience “high blood pressure” which was attributed to the Folic Acid intake, and possibly hereditary from my father who does have a history of it. I was then put on “METORAL” and asked to stop taking the “FOLIC ACID”

7) Six months later, I started showing new symptoms such as: Crossed eyes, extreme fatigue with feeling sleepy all the time, loss of my balance, and feeling weak in my legs. I was then taken to the hospital for a repeat of all the previous tests, the results of which came out all normal once again. I was seen by a rheumatologist who ruled out Rheumatisms. Some doctors even, attributed my symptoms to “Early Puberty”!

8) As I was emotionally distressed, I was seen by Psycho Therapist who put me on “LAMOTRIGINE” and “FLUOXETINE” and although I felt better emotionally, I was still not having a good balance, and was experiencing anxiety at school.

9) Since then and for nearly six years, I had been feeling well with the exception of two or three episodes of emotional distress, up until two months ago when many of the old symptoms came back, as I started not being able to walk normally, losing my balance, falling off frequently, and experiencing pain in my feet and legs, losing my appetite, and not being able to perform simple functions such as putting my shoes on or buttoning up my shirt.

10) I am fresh man computer science major in university, and though I have a very good comprehension of my academic subjects like: Physics, Mathematics, Programming, etc. I am however not able to concentrate and seem to be loosing my short term memory. I have also recently lost control of my bladder which has been resulting “Involuntary Night Urination”. I am also loosing my speech and the ability to speak and seem to be deteriorating fast!!

11) I was put on the following medicines but with no signs of any improvements:
a. LAMOBIOGINE
b. VENLAFAXINE
c. TRIHEXYPHENIDYL
D. SELEGILINE

12) The new MRI reading by my Neurologist indicates and/or speculates:
Parkinson Disease or Multiple Sclerosis, though he was not sure, however the secondary MRI test and Echocardiogram have reaffirmed his diagnosis of PD.

13) Here is a list of medicines that I am taking currently:
a. MINIRIN Spray 5mg (One Puff nightly)
b. LOMICROG (?)
c. LAMOBIOGINE 50 mg (Anticonvulsant)
d. AMLOTIDI (AMLODIPINE) 5mg (Twice daily morning & night)

Please kindly advise me by answering and or commenting on the following questions:

1) Should I continue taking my current medications?
2) If not what alternate medications are there in the market to use?
3) Should I exercise (walk, Swim, etc.) or not?
4) Is there any food or diet that I should start? (red meat verses white), eggs, dairy, salt or sweet, etc.
5) Lastly, do you recommend any medical institution or facility, in US and/or Europe, or is there any other treatment that I can continue on, in my home country of Iran where I am currently residing?

Thank you in advance for having taken the time to read my posting and god bless you all.

Sincerely,
Reza Fatemi

#2 Dr. Okun

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Posted 02 June 2011 - 07:30 AM

Please kindly advise me by answering and or commenting on the following questions:

1) Should I continue taking my current medications?

- It is unclear to me what the diagnosis is based on a complex history that does not sound classic for PD. Therefore I cannot make medication recommendations although a trial of high dose sinemet at some point may be considered (with pre- and post clinical testing by the UPDRS Parkinson's disease screening question)

2) If not what alternate medications are there in the market to use?

- Again, defer until your diagnosis is clear. Diagnosis of PD cannot be made on a MRI.

3) Should I exercise (walk, Swim, etc.) or not?

-Exercise is good for almost all neurological diseases.

4) Is there any food or diet that I should start? (red meat verses white), eggs, dairy, salt or sweet, etc.

-Defer until you get a diagnosis. Healthy diet in PD and be careful of protein tying up sinemet absorption.

5) Lastly, do you recommend any medical institution or facility, in US and/or Europe, or is there any other treatment that I can continue on, in my home country of Iran where I am currently residing?

-Go to a center of excellence for Parkinson;s disease or somewhere where you are confident they can sort out this very complex case.

Thank you in advance for having taken the time to read my posting and god bless you all.

-You are welcome
Michael S. Okun, M.D.
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips




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