Discussions By Condition: I cannot get a diagnosis.

Please help with my patient's diagnosis

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: acuann
  • January 3, 2009
  • 05:06 AM

I am an acupuncturist and have a patient who presents with all of the symptoms of Parkinsonism. She is 35 years old, and has suffered from Parkinson symptoms for over six years.

Currently she is taking cogentin to help her symptoms. At first, she was showing some improvement taking this med, but after three days her symptoms are back and she is progressively getting worse. She has also taken other Parkinson meds in the past with no benefit whatsover.

She has been to many many docs, and no diagnosis. In addition to her Parkinson symptoms she shows symptoms of "stiff person syndrome" but this has apparently been ruled out by a blood test.

She initially responded well to acupuncture, but I have not been able to halt or slow the progression of this disease.

If this were true Parkinson's wouldn't she be experiencing major improvements in her symptoms with the medications?

She had saline breast implants done less than a year before her symptoms first appeared...she just had them removed thinking they may have been leaking and causing her symptoms. She has also had a lot of emotional trauma in her life.

This is the first time I've posted a thread, and would appreciate any other advice or comments. Thanks for any insight you can provide. I'll try to answer any questions you may have.

Best wishes
DOM

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5 Replies:

  • I presume that she's been on L-DOPA.What about Symmetrel?What meds exactly has she been on?
    richard wayne2b 1232 Replies
    • January 3, 2009
    • 01:18 PM
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  • If you don't mind, could you provide the most precise and descriptive list of your patient's symptoms? This would include the earliest symptom recalled and progression since onset, and also any change in facial features or expression as well. If the patient has been experiencing symptoms for 6 years, then she would have been 29 at onset and the differentials among early-onset PD might prove beneficial at this point, particularly in light of the fact that anti-Parkinson drugs have not demonstrated any effect, which I have to tell you would be exceedingly rare. Of interest as well, is the mention of intense psychological trauma and I would be interested to know exactly what medications, if any, had been prescribed or that she is presently taking to address this issue. I ask because we traditionally do not use Cogentin as a primary therapeutic course for Parkinson's disease, but rather to countermand Parkinson-like effects demonstrated as a side-effect of certain psychotropics. The fact that the patient demonstrated brief improvement may have some significance. Incidentally, the saline implants would be non-contributory. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 3, 2009
    • 02:42 PM
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  • I presume that she's been on L-DOPA.What about Symmetrel?What meds exactly has she been on? Yes she has been on L Dopa, but I don't think she was prescribed symmetrel. I will check my notes and get back to you with a more thorough list of meds she has taken. Mr. Cottle: I will also answer more of your questions when I check my notes concerning meds she was prescribed. She has nearly all of the symptoms of classic Parkinson's. She has resting tremors in her hands and feet, both sides. She has a "mask" face with very little expression. She writes in very small handwriting that tapers off. She walks VERY slowly with a shuffle. She has muscle rigidity that has worsened. Her muscle rigidity is along her spine and pretty much all limbs. She shows hardly any emotions, though is clearly frustrated with her situation. I know I need to elaborate more on her psychological issues, and want to give correct info when I get my notes. I will update soon on this. I appreciate your responses. This to me is very odd to experience these symptoms and not have any relief from Parkinson's meds. She has even been to the Mayo clinic in AZ where they essentially found no answers. Best wishesDOM
    acuann 3080 Replies
    • January 3, 2009
    • 04:04 PM
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  • I eagerly await your results.
    richard wayne2b 1232 Replies
    • January 3, 2009
    • 04:30 PM
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  • I am sorry about your pt. however I had a question about an answer you gave to another thread where you suggested probiotics and yogurt for bv?! Does this treat your partner as well? As for your pt. I have lupus sle and fibromyalgia and have some of those symptoms. An antimalarial helped with a mix of anticonvulsants as well. She should be tested for all these things Good lck! Thanks
    Whoa575 3 Replies Flag this Response
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