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DaTscan and Diagnosis Difficulties

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One option docs will sometimes try when there is uncertainty in diagnosis is to treat with Sinemet and repeat and compare the DAT scan in one year.  We only treat if the symptoms are bothering the person on interfering with the quality of life.  Hope that helps.

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On 2/25/2018 at 6:05 AM, Dr. Okun said:

One option docs will sometimes try when there is uncertainty in diagnosis is to treat with Sinemet and repeat and compare the DAT scan in one year.  We only treat if the symptoms are bothering the person on interfering with the quality of life.  Hope that helps.

 I truly thank you for your response. I realize I sent a lot of information and it is impossible to diagnose someone over the internet. I have been entertaining the idea of rescanning in a few more months. Based on my current symptoms and knowledge I still have a few remaining questions if you have any insight to help answer.

1. Is a abnormal symmetrical DaTscan very common? If it continues to be abnormal or continued for the worse “symmetrically” I would assume maybe atypical Parkinson’s, Lewy Bodies or some sort of toxin or exposure to an outside factor causing Parkinsonism...?

2. If I were to try Sinemet prior to motor function problems to possibly aid my secondary type symptoms would this be reducing the potential lifespan as to how long Sinemet would aid potential motor function problems down the road? It seems many say to wait to use L-Dopa type meds as long as possible as it only has a few years of benefit for relief of motor symptoms..?

3. If a patient took Sinemet and months or years later showed no evidence of Parkinson’s or Parkinsonism. Is there any potential harm if a healthy patient took Sinemet for a period of time and then discontinued? Wondering if the patients dopamine production would somewhat be reduced or diminished due to the use of the medication. I would assume some sort of withdrawal would be likely until things readjusted however I realize in asking this that it is a likely uncommon scenario to have an answer for. 

Thank you you again for any input you can help with!

 

Edited by Doubleup

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Abnormal DAT scans are common in movement practice but only tell the doc that there is an abnormality in the dopamine transporter.  Rescanning over time to track disease progression has not been to date shown useful.  You can try Sinemet without causing down the road problems.  If you try sinemet and you do not have PD there is no evidence to date that this is harmful.

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Thank you, I suppose time will be the only way to truly diagnose this for me. My fears are more of possibility Lewy Body Disease since my scan was bilaterally abnormal and some symptoms are similar however I am sure there are plenty of other possibilities as well and shouldn't jump to conclusions. 

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