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idiopathic pd vs parkinsonism


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#1 vipowitz

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Posted 28 April 2013 - 08:28 PM

Hello Dr Okun,, What observations of symptoms might a well trained MDS need to observe in order to make the diagnosis of parkinsonism as opposed to idiopathic PD relating to a patient just 1 year after patient was diagnosed with pd (assuming the patient was carbo/levo responsive)?

#2 Dr. Okun

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Posted 30 April 2013 - 02:49 PM

It can be tricky at the one year time point to make a definitive diagnosis.

The presence of autonomic issues that are severe or ataxia may for example make you think about MSA.

Falling or problems with vertical (up-down) eye movements may make you think of PSP.

Problems with skilled movements (praxis) or an alien limb may make you think of CBD.

It is best to start with an excellent neurological examination and then to test the response to dopamine therapies...and of course follow the patient over time.
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

#3 vipowitz

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Posted 30 April 2013 - 08:15 PM

how ould severe autonomic issues present, and, assuming the mds suspects possible msa , what type of progression would be likely present after 2 years?

#4 Dr. Okun

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Posted 01 May 2013 - 01:23 PM

Progression varies, but problems with dizziness, blood pressure, erectile dysfunction, bladder, and constipation all can occur.....but these also can occur in PD.
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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