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Pauli Schrage Bailey

Parkinsonism caused by past pituitary adenoma (or craniopharyngioma)?

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I'm a 43-year-old woman who just recently started exhibiting symptoms consistent with Parkinsonism. In 1999, I was diagnosed with what was either an atypical non-functioning pituitary macroadenoma -or- an atypical craniopharyngioma (my doctors settled on calling it the former, but it had characteristic of both). The tumor measured 1" x 0.75", and it was surgically removed via the transspheniodal approach.

 

My question - Is it physically possible that my tumor had pressed against my substantia nigra? I've been trying to find a good brain diagram that shows the substantia nigra in relation to the pituitary (or optic chasm), but I can't seem to find one that clearly shows both regions. From the diagrams I *have* found, I believe there's bone between the two regions. That said, the pressure of my tumor did create a hole in my sphenoid sinus bone, so it seems conceivable that it could have eroded the posterior bone to the point that it was thin enough for pressure to be felt on its other side... but I'm just guessing.

 

My thought is that *perhaps* nature intended for me to get PD later in life, and thus my dopamine-producing cells have just recently started to die off slowly. It would have normally taken decades to reach the 80% cell death point where symptoms start to show, but because the pressure of my tumor caused, say, 70% of the cells to die prematurely, I only had to lose 10% of them "naturally" before exhibiting symptoms.

 

Does my "theory" have any scientific merit? I realize I may be trying to connect unrelated dots. It just seems too coincidental that I'd have two non-related brain issues at my relatively young age, but such things do happen.

 

Thanks in advance for your kind help! :)

 

P.S. I doubt that taking a dopamine agonist earlier in life would cause Parkinsonism later on, but I'll just add that I *did* take bromocriptine for six months in a "hail Mary" effort to shrink my tumor a little bit before surgery. My prolactin was slightly high so my docs thought the tumor *might* be a wimpy prolactinoma. Of course it wasn't, so the tumor didn't shrink. Instead, compression of my pituitary stalk wasn't letting enough dopamine through (and therefore it wasn't inhibiting as much prolactin as it should have been).

 

 

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It is highly unlikely that your issues caused a compressive PD.  It is more likely that you had PD and the stress and maybe compression made things worse.

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UPDATE: My problem was that I was very, very low on vitamin B12. Physicians need to do a better job at ruling out B12 deficiency before they send their patients for expensive tests & scare them with horrible neurological disease diagnoses. It was only after *my* research and *my* request to have my vitamin B12 tested that the cause of all my issues was revealed. I can understand my PCP missing it, but it’s unexcusable that my neurologist did. It should have been the FIRST thing he ruled out.

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