my mother's fingers tremors at rest and we went see a doctor but the doctor said that it has to tremor all the time to be a parkinson disease. but i just don't feel good watching my mom's finger tremors at times and not sure what to do to convince the doctor to examine her in more details?
( there was one time i saw her half body tremors while she stars at TV without any emotions...it only happened once but that just scares me and i really fear there is something wrong with her...) the tremors happens here and there (not all the time) so when we saw the doctor it was not happening and the doctor said that it has to be all the time to be a parkinson...but i checked the internet that seems to say otherwise??? not sure if i understand the internet correctly? It could also not be parkinsons, it could be a degeneration of her nervous system that comes with age?
Does she drink coffee? That makes me go wild when i stay still.. i mean, REALLY wild it scares me shitless sometimes :s
But if you feel the doctor is not doing their best job, get another doctor to doublecheck!
go to a specialist, like a neurologist... or specialized clinics...
Just try not to be too freaked out over what could be nothing. But good luck, and keep an eye out just to be sure :)
the internet is that, internet. all the info is there. a doctor has YEARS of training to determine when a patient is sick or not (im in med school, after a while, you stop freaking out and know that some things just dont happen because hte internet says so)
:) take her to a specialist and get a second opinion i would go to webmd and read as much as possible about parkinson's disease and also a condition known as parkinsonism. these are two different conditions from what i understand. i would also assume your mother is not a very young person so i would get her to a geriactic doctor as they are very astute to elderly and their conditions. as i said, my first suggestion would be to read as much as possible about her symptoms Benign Essential Tremors
Synonyms
Presenile Tremor Syndrome
Tremor, Familial Essential
Tremor, Hereditary Benign
Disorder Subdivisions
None
General Discussion
Benign Essential Tremor is a neurologic movement disorder characterized by involuntary fine rhythmic tremor of a body part or parts, primarily the hands and arms (upper limbs). In many affected individuals, upper limb tremor may occur as an isolated finding. However, in others, tremor may gradually involve other anatomic regions, such as the head, voice, tongue, or roof of the mouth (palate), leading to difficulties articulating speech (dysarthria). Less commonly, tremor may affect muscles of the trunk or legs.
In individuals with the condition, tremor tends to occur while voluntarily maintaining a fixed posture against gravity ("postural tremor") or while performing certain goal-directed movements ("kinetic intention tremor"). Although tremor is typically absent with rest--i.e., when the affected muscle is not voluntary activated--some individuals with advanced disease may develop resting tremors.
Although symptom onset may occur during childhood or adolescence, the condition most commonly becomes apparent during adulthood, at an average age of 45 years. Benign Essential Tremor is generally considered a slowly progressive disorder. Disease progression is characterized by an increase in tremor amplitude, causing difficulties in performing fine motor skills and varying degrees of functional disability. For example, hand tremor may gradually cause difficulties with manipulating small objects, drinking fluids from a glass, eating, writing, or dressing. (As mentioned above, in some affected individuals, disease progression may also include extension of tremor to other muscle groups.)
Benign Essential Tremor may appear to occur randomly for unknown reasons (sporadically) or be transmitted as an autosomal dominant trait. Researchers suggest that changes (mutations) of different genes may be responsible for the disorder (genetic heterogeneity). For example, during genetic analysis of several affected families (kindreds), investigators located a gene for the disorder, known as "FET1," on the long arm (q) of chromosome 3 (3q13). In another kindred, the disorder was determined to result from mutations of a gene, designated "ETM2," on the short arm (p) of chromosome 2 (2p22-p25).
Resources
WE MOVE (Worldwide Education and Awareness for Movement Disorders)
204 West 84th Street
New York, NY 10024
USA
Tel: 2128758312
Fax: 2128758389
Email: wemove@wemove.org
Internet: http://www.wemove.org
International Essential Tremor Foundation
11111 West 95th Street
Suite 260
Overland Park, KS 66214-1824
USA
Tel: 9133413880
Fax: 9133411296
Tel: 8883873667
Email: Staff@essentialtremor.org
Internet: http://www.essentialtremor.org
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
Tel: (914)428-7100
Fax: (914)997-4763
Tel: (888)663-4637
Email: Askus@marchofdimes.com
Internet: http://www.marchofdimes.com
National Institute of Neurological Disorders and Stroke (NINDS)
31 Center Drive
8A07
Bethesda, MD 20892-2540
Tel: (301)496-5751
Fax: (301)402-2186
Tel: (800)352-9424
Email: braininfo@ninds.nih.gov
Internet: http://www.ninds.nih.gov/ Not all tremors are indicative of Parkinson's disease
The neurological disorder affects approximately 1 million people in North America
Parkinson's disease is a neurological disorder of movement first described by James Parkinson in the early 1800's. Movement disorders in neurology are distinct disorders compared to other neurological disorders.
The diagnosis of most movement disorders are based on clinical findings (history and physical exam) rather than neuro-imaging studies such as a CAT scan or an MRI. There is a famous quote that states "not all tremors are Parkinson's disease," and this is quite true. However, when someone has a tremor, the concern that most of us have is, is it Parkinson's disease.
Parkinson's disease is a progressive neurological disorder, in which parts of the brain produce a chemical called dopamine degenerate. The diagnostic criteria for Parkinson's disease includes a tremor, however, it is a very characteristic resting tremor or pill-rolling tremor.
Other features of Parkinson's disease include small handwriting, slowness of movement and stiffness. Memory loss and depression are also common conditions associated with Parkinson's disease and must be addressed. There are some medicines such as Reglan and psychiatric medications, which can cause Parkinsonian features.
Tremors can be classified based on their speed and overall appearance. A majority of tremors are essential for postural tremors. These tremors occur when someone has their arms or legs outstretched. These tremors are defined by being very fast and moving very small distances. The most common cause of this type of tremor is genetic or related to thyroid disease.
Parkinson's disease is the most common movement disorder, in which slowness of movement is characteristic. Currently, a study is being conducted in Staten Island to chart the prevalence of Parkinson's disease. There appears to be approximately 1 million people with Parkinson's disease in North America.
The average age of onset is 60, however, 15 percent of patients get it under the age of 50 and 10 percent under age 40. We are all familiar with Michael J. Fox and his condition, which began in his early 30s.
The cause of Parkinson's disease is not known. We currently know there is an environmental component and a genetic one. It's controversial whether certain toxins in the environment, such as, manganese from welding or pesticides may be contributing to Parkinson's disease.
TREATING THE DISORDER
The treatment for Parkinson's disease involves replacing the chemical dopamine, which is diminished in the brain. Dopamine cannot directly get into the brain; therefore, L-Dopa (a precursor of Dopamine) is used in the medicine called Sinemet. Medications that stimulate the dopamine receptor (dopamine agonist) are very successful in treatment of Parkinson's disease.
In advanced Parkinson's disease, major symptoms can include stiffness and walking problems. Often people with advanced Parkinson's become more sensitive to the medication and can have twitching movements called dyskinesias that can affect functions.
In patients with a more advanced case or who cannot tolerate medications, surgical interventions (deep brain stimulation) can be performed for slowness of movement, stiffness and tremor. As in other neurological fields we are on the cutting edge of new treatments and technologies both to define Parkinson's disease and treat it.
A new agent called Rasagiline is available and may be neuro-protective in slowing down the progression of Parkinson's disease. We await future novel treatments such as nerve growth factors and stem cell research.
As critical as new therapies are to the patient, caregiver support is fundamental for the functioning of the whole family. Organizations such as the Grasmere-based American Parkinson Disease Association (718-390-4989) and other support groups help families get through difficult times. At present, there is more hope and treatment for people with Parkinson's disease.
This column is provided by the Richmond County Medical Society. Questions may be sent to the column in care of the Advance. |
