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Post of the Week: 3 Symptoms that Precede the Diagnosis of PD


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#1 Dr. Okun

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Posted 03 October 2010 - 01:14 PM

Dear Forum Members,

Last week at the World Parkinson Congress in Scotland there was a lot of discussion about symptoms that precede the diagnosis of PD.

Three of these discussed included olfaction (smell) which may precede by less than 5 years, REM sleep disorder (acting out your dreams and vivid dreams) which may precede by 10-12 years, and constipation which is less studied in terms of lead time.

The identification of early indicators of PD will be important for the field once we have disease modifying therapies.

We will keep you posted.
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

#2 gmk

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Posted 20 October 2010 - 02:50 PM

Dear Forum Members,

Last week at the World Parkinson Congress in Scotland there was a lot of discussion about symptoms that precede the diagnosis of PD.

Three of these discussed included olfaction (smell) which may precede by less than 5 years, REM sleep disorder (acting out your dreams and vivid dreams) which may precede by 10-12 years, and constipation which is less studied in terms of lead time.

The identification of early indicators of PD will be important for the field once we have disease modifying therapies.

We will keep you posted.

Unexpected and repeated FALL/S + ev. with a complication, such as fracture, especially, in a person (Age 50+), "anxiety"-on-exertion,
"depression", trouble with urination, not just the constipation may be early indicator/s preceeding diagnosis of PDs.
gmk

#3 Dr. Okun

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Posted 21 October 2010 - 07:32 AM

Thanks for the post.

Early falls preceding the diagnosis may be a sign of another syndrome (PSP, etc.).

Certainly anxiety and depression can be the first symptom.

I am unaware of early urinary incontinence being an issue, but certainly I have heard changes in urinary frequency and pattern. Early incontinence may also herald Normal Pressure Hydrocephalus.

Again, thanks for the great comments on early presentations.
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

#4 Ljubica Lojan

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Posted 21 October 2010 - 11:46 AM

Dear Dr Okun,

You mentioned the smell preceding PD. What about smell? Does the smell decrease pprior to PD?
Thank you.
Emily

#5 Dr. Okun

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Posted 22 October 2010 - 09:51 AM

Emily,

Yes studies have shown certain smells are more commonly affected early in PD.

Banana, Licorice, and Dill Pickle are the early smells that may be affected.
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

#6 RandyL3

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Posted 24 October 2010 - 08:51 PM

Dr. Okun,

I'm curious about my situation regarding smells. Since being diagnosed with Parkinsons my sense of smell has become more acute. Some smells appear to me to be so strong they become almost nauseating. Another curious thing is that it seems like my brain remembers smells that are no longer present. For example, I'll be driving and get behind a vehicle emitting a strong exhaust odor, like a diesel engine. For almost 10 min. after the vehicle is gone I can still smell the diesel. It happens with other things also. Are either of these situations known to exist with Parkinsons people?

Thanks,
Randy

#7 Dr. Okun

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Posted 25 October 2010 - 06:52 AM

Very interesting Randy. I will post for you. I have not heard about this effect, but anything is possible. In some neurological aliments one sense may become sharper.
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

#8 shell

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Posted 25 October 2010 - 10:04 PM

Emily,

Yes studies have shown certain smells are more commonly affected early in PD.

Banana, Licorice, and Dill Pickle are the early smells that may be affected.


There is a ritual that religeous Jews perform every Saturday night at the end of the Sabbath that involves in one part the smelling of certain spices. Cloves are generally one of the spices. For quite a while I kept telling my wife to make sure the clove container is tightly shut so as they should not lose their odor so quickly. I did not realize it was my sense of smell that was playing games. This was at least a year prior to my being diagnnosed with PD.

#9 gmk

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Posted 26 October 2010 - 03:38 PM

Dear Forum Members,

Last week at the World Parkinson Congress in Scotland there was a lot of discussion about symptoms that precede the diagnosis of PD.

Three of these discussed included olfaction (smell) which may precede by less than 5 years, REM sleep disorder (acting out your dreams and vivid dreams) which may precede by 10-12 years, and constipation which is less studied in terms of lead time.

The identification of early indicators of PD will be important for the field once we have disease modifying therapies.

We will keep you posted.

If a symptom/sign qualifies for one preceeding the diagnosis of PD, criteria should be set and first of them would be that it improves with therapy,
specifically, it is L-DOPA responsive.
gmk

#10 Dr. Okun

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Posted 27 October 2010 - 06:17 AM

gmk

Diagnosis and treatment should be kept separate. Some symptoms respond to therapy and some do not. Now, you can classify in an individual patient which symptoms respond over time....but for diagnosis I would not recommend using symptom responsiveness for every PD symptom.

Thanks for the thoughtful comment.
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

#11 Guest_TonyaV_*

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Posted 29 October 2010 - 02:51 PM

Dr. Okun,

I'm curious about my situation regarding smells. Since being diagnosed with Parkinsons my sense of smell has become more acute. Some smells appear to me to be so strong they become almost nauseating. Another curious thing is that it seems like my brain remembers smells that are no longer present. For example, I'll be driving and get behind a vehicle emitting a strong exhaust odor, like a diesel engine. For almost 10 min. after the vehicle is gone I can still smell the diesel. It happens with other things also. Are either of these situations known to exist with Parkinsons people?

Thanks,
Randy



Randy,

What you described is the same for me. My sense of smell is more acute, also. I can smell things that no one around me can smell and I also smell odors for a longer period of time like you explained with the diesel. I've had this "extrasensory smell thing" going on for several years.
Interesting...

Tonya

#12 Dr. Okun

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Posted 29 October 2010 - 06:23 PM

Really interesting. I will post to see if others have experienced the same thing!
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

#13 RandyL3

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Posted 30 October 2010 - 10:04 PM

Randy,

What you described is the same for me. My sense of smell is more acute, also. I can smell things that no one around me can smell and I also smell odors for a longer period of time like you explained with the diesel. I've had this "extrasensory smell thing" going on for several years.
Interesting...

Tonya


Hi Texas T,

I wondered if anyone else shared this experience or if I was just a "weird" one. If two of us have the same thing I'd imagine there are others. It's an interesting sensation, sometimes a bit annoying.

Randy

#14 shooter

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Posted 02 November 2010 - 12:25 PM

An extra sensitive sniffer w/some odors i have for a time also

#15 Dr. Okun

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Posted 02 November 2010 - 03:43 PM

I asked a smell expert in PD (a researcher) and he has seen many patients but not heard of this in PD except for smell hallucinations.....which it doesn't sound like that at all.

This is very interesting.
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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