Re: report from a self-made guinea pig

[Guest guest]

I've added some in black, Bill Werre

Maybe we could have a plain language project among

ourselves. Please fill in layman's terms after the '='

The differential diagnosis of parkinsonism

accompanied by

atypical features

= not normal

is broad and

includes the Parkinsonism Plus

syndromes=

constellation of symptoms

(multisystem atrophies,

progressive supranuclear palsy,

= PSP

cortical-basal ganglionic degeneration,

= CBGD

progressive pallidal atrophy,

diffuse Lewy body disease), =

Ken had this - much like MSA

Alzheimer's disease with parkinsonian

features,

Pick's disease,

hederodegenerative diseases ('s,

Hallervorden-Spatz, Huntington's disease, etc.),

and secondary parkinsonism =

second to another medical condition, medication or toxin (poisin)

(vascular, =

to

do with blood and it's circulation

drug induced, =

caused by drugs

infection, =

hope we know that

prion disease,

= like mad cow disease - actually

most Parkinson's Plus disorders fit this description

toxins,

cadmium

would be an example - actually opiates are

considered here also

trauma, =

blow to the head for example

mass lesions, =

scarring all over (from demyelating disease etc.)

hydrocephalus, =

water

on the brain

hypothyroidism, =

underfunctioning

thyroid

paraneoplastic, - pertaining

to Hormonal, neurological, haematological, and other clinical and biochemical

disturbances associated with malignant neoplasms but not directly related

to invasion by the primary tumour or its metastases.

hepatocerebral degeneration, and

- sorry no clue

syringomesencephalia). - ?

may be related to problems of the sweat glands

Of the various causes, the Parkinsonism

Plus syndromes and secondary parkinsonism are the most common.

Hederodegenerative

diseases are relatively uncommon,

and this patient did not fit into any of the recognized patterns of hederodegenerative

disease. = some sort of ivy shaped nerves

I think

The patient's mild

subcortical dementia =Relating

to the subcortex; beneath the cerebral cortex.

and the presence of

cerebellar signs =concerned

primarily with somatic motor function, the control of muscle tone and the

maintenance of balance

did not fit the pattern expected

for either Alzheimer's or Pick's disease. Infectious possibilities include

encephalitis lethargica, = viral brain infection (leeping sickness)

HIV, = AIDS

syphilis, and

SSPE. =Subacute

sclerosing panencephalitis = ask a neuro

In this case, serologic tests excluded

syphilis and HIV infection, and the clinical course and features were not

consistent with encephalitis lethargica or SSPE (which are rapidly progressive

conditions). There was no history of anti-psychotic or anti-emetic drug

exposure, toxin (CO, Mn, Hg, MPTP, CS2, methanol, cyanide) exposure, multiple

head traumas, multiple strokes, or metabolic abnormalities. Prion diseases,

especially Creutzfeldt-Jakob and Gerstmann-Straussler-Scheinker disease,

present with a more rapid, aggressive course and more profound dementia.

Neuroimaging excluded the possibility of hydrocephalus and mass lesions.

One might consider the possibility of normal pressure hydrocephalus, consisting

of the triad of dementia, gait disturbance, and urinary incontinence. The

mild subcortical dementia is consistent with this diagnosis, but the lack

of improvement of this patient's leg function on lying down argues against

it. Neuroimaging was not consistent with this diagnosis.

The Parkinsonism Plus syndromes

include an array of neurodegenerative conditions characterized by parkinsonism

plus other evidence of neurological dysfunction as seen in our patient.

In Diffuse Lewy Body disease, parkinsonism is accompanied by cortical dementia

with varying levels of attention, early hallucinations, and psychosis.

Autonomic dysfunction is common, and

pyramidal signs =

may be seen, but

cerebellar dysfunction= somatic

motor function, the control of muscle tone and the maintenance of balance

are not working

is not found. This patient's

mild subcortical dementia is also not consistent with this diagnosis. In

cortical-basal ganglionic degeneration, parkinsonism is accompanied by

ideomotor apraxias, =

the alien limb phenomenon, = dystonia

= extreme muscle cramp resulting in loss of movement with limb in permanent

cramp

cortical reflex myoclonus, =

cortical sensory loss, =

marked asymmetry of involvement,

=one side of body affected more than the other

and

focal rigidity =

and

dystonia ==

extreme muscle cramp resulting in loss of movement with limb in permanent

cramp

with

contractures. =

None of these features was seen

in this patient. In progressive supranuclear palsy, parkinsonism is accompanied

by a

prominent supranuclear gaze disturbance

=

not seen in this patient.

Multisystem atrophy (MSA) is a

progressive, = gets

worse

sporadic =

all

over the place, unpredictable

disorder characterized by parkinsonism

in association with varying degrees of

cerebellar, = pertaining

to loss of somatic motor function, the control of muscle tone and the maintenance

of balance

pyramidal, = Charlotte

had this, can't remember exactly what it was

intellectual, = thought

processing ability

and

autonomic dysfunction. =

unable to control function which should not require thought (breathing,

heart rate, thermoregulation)

Classically, this includes three

separate entities -

Striatonigral degeneration (parkinsonism

poorly responsive to levodopa and frequently associated with cervical dystonia),

= cervical dystonia = rigid back= rigidity

Olivopontocerebellar atrophy (parkinsonism

with cerebellar dysfunction), = OPCA = movement,

and balance problems

and

Shy-Drager syndrome (parkinsonism

with autonomic dysfunction). = automatic refluxes

not working properly i.e. OH, temperature control no good

Because of the clinical overlap

and common pathologic finding of an

intracytoplasmic oligodendroglial

inclusion body, =

these entities are now lumped together.

This patient best fit the diagnosis of multisystem atrophy with evidence

of parkinsonism, cerebellar dysfunction, autonomic dysfunction, mild dementia,

and

long-tract signs. =

Geez it can really make your head

hurt!

aletta mes

vancouver, bc Canada

web:

http://aletta.0catch.com

If you do not wish to belong to shydrager, you may

unsubscribe by sending a blank email to

shydrager-unsubscribe

[Guest guest]

I have a couple additions and corrections to the below.

Bill! Where did you get "some sort of ivy-shaped nerves"??? LOL ... ok they did misspell the word "hederodegenerative" it's "heredodegenerative".

Heredodegenerative: Pertaining to genetically transmitted (hereditary) neurologic disorders characterized by progressive neuronal loss and other neurodegenerative changes.

I think this is a better definition of Sporadic when referring to a disease:

From Webster's Dictionary: Sporadic disease (Med.), a disease which occurs in single and scattered cases.

progressive pallidal atrophy --> don't know but I'll look it up

Pick's Disease --> that's a frontal lobe dementia

Prion Disease --> I didn't think PD or PD+ disorders really fell under this category... Bill do you have an article about that?

hepatocerebral degeneration --> Don't know that one either.

paraneoplastic --> there are paraneoplastic ataxias... resulting from cancer of the ovary, breast or lung.

A couple new people on the list recently have mentioned "normal pressure hydrocephalus" Note it has similarities to some MSA symptoms --- dementia, gait disturbance, and urinary incontinence. I read it's hard to diagnose.

That's all I have time for today.

Hugs,

Pam

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 1:19 AMTo: shydrager Subject: Re: report from a self-made guinea pig I've added some in black, Bill Werre

Maybe we could have a plain language project among ourselves. Please fill in layman's terms after the '=' The differential diagnosis of parkinsonism accompanied by

atypical features = not normal

is broad and includes the Parkinsonism Plus

syndromes= constellation of symptoms (multisystem atrophies, progressive supranuclear palsy, = PSP cortical-basal ganglionic degeneration, = CBGD progressive pallidal atrophy, diffuse Lewy body disease), = Ken had this - much like MSA Alzheimer's disease with parkinsonian features, Pick's disease, hederodegenerative diseases ('s, Hallervorden-Spatz, Huntington's disease, etc.), and secondary parkinsonism = second to another medical condition, medication or toxin (poisin) (vascular, = to do with blood and it's circulation drug induced, = caused by drugs

infection, = hope we know that

prion disease, = like mad cow disease - actually most Parkinson's Plus disorders fit this description toxins, cadmium would be an example - actually opiates are considered here also trauma, = blow to the head for example mass lesions, = scarring all over (from demyelating disease etc.) hydrocephalus, = water on the brain hypothyroidism, = underfunctioning thyroid paraneoplastic, - pertaining to Hormonal, neurological, haematological, and other clinical and biochemical disturbances associated with malignant neoplasms but not directly related to invasion by the primary tumour or its metastases. hepatocerebral degeneration, and - sorry no clue syringomesencephalia). - ? may be related to problems of the sweat glands Of the various causes, the Parkinsonism Plus syndromes and secondary parkinsonism are the most common. Hederodegenerative diseases are relatively uncommon, and this patient did not fit into any of the recognized patterns of hederodegenerative disease. = some sort of ivy shaped nerves I think The patient's mild subcortical dementia =Relating to the subcortex; beneath the cerebral cortex. and the presence of cerebellar signs =concerned primarily with somatic motor function, the control of muscle tone and the maintenance of balance did not fit the pattern expected for either Alzheimer's or Pick's disease. Infectious possibilities include encephalitis lethargica, = viral brain infection (leeping sickness) HIV, = AIDS syphilis, and SSPE. =Subacute sclerosing panencephalitis = ask a neuro In this case, serologic tests excluded syphilis and HIV infection, and the clinical course and features were not consistent with encephalitis lethargica or SSPE (which are rapidly progressive conditions). There was no history of anti-psychotic or anti-emetic drug exposure, toxin (CO, Mn, Hg, MPTP, CS2, methanol, cyanide) exposure, multiple head traumas, multiple strokes, or metabolic abnormalities. Prion diseases, especially Creutzfeldt-Jakob and Gerstmann-Straussler-Scheinker disease, present with a more rapid, aggressive course and more profound dementia. Neuroimaging excluded the possibility of hydrocephalus and mass lesions. One might consider the possibility of normal pressure hydrocephalus, consisting of the triad of dementia, gait disturbance, and urinary incontinence. The mild subcortical dementia is consistent with this diagnosis, but the lack of improvement of this patient's leg function on lying down argues against it. Neuroimaging was not consistent with this diagnosis. The Parkinsonism Plus syndromes include an array of neurodegenerative conditions characterized by parkinsonism plus other evidence of neurological dysfunction as seen in our patient. In Diffuse Lewy Body disease, parkinsonism is accompanied by cortical dementia with varying levels of attention, early hallucinations, and psychosis. Autonomic dysfunction is common, and pyramidal signs = may be seen, but cerebellar dysfunction= somatic motor function, the control of muscle tone and the maintenance of balance are not working is not found. This patient's mild subcortical dementia is also not consistent with this diagnosis. In cortical-basal ganglionic degeneration, parkinsonism is accompanied by ideomotor apraxias, = the alien limb phenomenon, = dystonia = extreme muscle cramp resulting in loss of movement with limb in permanent cramp cortical reflex myoclonus, = cortical sensory loss, = marked asymmetry of involvement, =one side of body affected more than the other and focal rigidity = and dystonia == extreme muscle cramp resulting in loss of movement with limb in permanent cramp with contractures. = None of these features was seen in this patient. In progressive supranuclear palsy, parkinsonism is accompanied by a prominent supranuclear gaze disturbance = not seen in this patient. Multisystem atrophy (MSA) is a progressive, = gets worse sporadic = all over the place, unpredictable disorder characterized by parkinsonism in association with varying degrees of cerebellar, = pertaining to loss of somatic motor function, the control of muscle tone and the maintenance of balance pyramidal, = Charlotte had this, can't remember exactly what it was intellectual, = thought processing ability and autonomic dysfunction. = unable to control function which should not require thought (breathing, heart rate, thermoregulation) Classically, this includes three separate entities - Striatonigral degeneration (parkinsonism poorly responsive to levodopa and frequently associated with cervical dystonia), = cervical dystonia = rigid back= rigidity Olivopontocerebellar atrophy (parkinsonism with cerebellar dysfunction), = OPCA = movement, and balance problems and Shy-Drager syndrome (parkinsonism with autonomic dysfunction). = automatic refluxes not working properly i.e. OH, temperature control no good Because of the clinical overlap and common pathologic finding of an intracytoplasmic oligodendroglial inclusion body, = these entities are now lumped together. This patient best fit the diagnosis of multisystem atrophy with evidence of parkinsonism, cerebellar dysfunction, autonomic dysfunction, mild dementia, and long-tract signs. = Geez it can really make your head hurt!

aletta mes vancouver, bc Canada web: http://aletta.0catch.com If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

I have a couple additions and corrections to the below.

Bill! Where did you get "some sort of ivy-shaped nerves"??? LOL ... ok they did misspell the word "hederodegenerative" it's "heredodegenerative".

Heredodegenerative: Pertaining to genetically transmitted (hereditary) neurologic disorders characterized by progressive neuronal loss and other neurodegenerative changes.

I think this is a better definition of Sporadic when referring to a disease:

From Webster's Dictionary: Sporadic disease (Med.), a disease which occurs in single and scattered cases.

progressive pallidal atrophy --> don't know but I'll look it up

Pick's Disease --> that's a frontal lobe dementia

Prion Disease --> I didn't think PD or PD+ disorders really fell under this category... Bill do you have an article about that?

hepatocerebral degeneration --> Don't know that one either.

paraneoplastic --> there are paraneoplastic ataxias... resulting from cancer of the ovary, breast or lung.

A couple new people on the list recently have mentioned "normal pressure hydrocephalus" Note it has similarities to some MSA symptoms --- dementia, gait disturbance, and urinary incontinence. I read it's hard to diagnose.

That's all I have time for today.

Hugs,

Pam

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 1:19 AMTo: shydrager Subject: Re: report from a self-made guinea pig I've added some in black, Bill Werre

Maybe we could have a plain language project among ourselves. Please fill in layman's terms after the '=' The differential diagnosis of parkinsonism accompanied by

atypical features = not normal

is broad and includes the Parkinsonism Plus

syndromes= constellation of symptoms (multisystem atrophies, progressive supranuclear palsy, = PSP cortical-basal ganglionic degeneration, = CBGD progressive pallidal atrophy, diffuse Lewy body disease), = Ken had this - much like MSA Alzheimer's disease with parkinsonian features, Pick's disease, hederodegenerative diseases ('s, Hallervorden-Spatz, Huntington's disease, etc.), and secondary parkinsonism = second to another medical condition, medication or toxin (poisin) (vascular, = to do with blood and it's circulation drug induced, = caused by drugs

infection, = hope we know that

prion disease, = like mad cow disease - actually most Parkinson's Plus disorders fit this description toxins, cadmium would be an example - actually opiates are considered here also trauma, = blow to the head for example mass lesions, = scarring all over (from demyelating disease etc.) hydrocephalus, = water on the brain hypothyroidism, = underfunctioning thyroid paraneoplastic, - pertaining to Hormonal, neurological, haematological, and other clinical and biochemical disturbances associated with malignant neoplasms but not directly related to invasion by the primary tumour or its metastases. hepatocerebral degeneration, and - sorry no clue syringomesencephalia). - ? may be related to problems of the sweat glands Of the various causes, the Parkinsonism Plus syndromes and secondary parkinsonism are the most common. Hederodegenerative diseases are relatively uncommon, and this patient did not fit into any of the recognized patterns of hederodegenerative disease. = some sort of ivy shaped nerves I think The patient's mild subcortical dementia =Relating to the subcortex; beneath the cerebral cortex. and the presence of cerebellar signs =concerned primarily with somatic motor function, the control of muscle tone and the maintenance of balance did not fit the pattern expected for either Alzheimer's or Pick's disease. Infectious possibilities include encephalitis lethargica, = viral brain infection (leeping sickness) HIV, = AIDS syphilis, and SSPE. =Subacute sclerosing panencephalitis = ask a neuro In this case, serologic tests excluded syphilis and HIV infection, and the clinical course and features were not consistent with encephalitis lethargica or SSPE (which are rapidly progressive conditions). There was no history of anti-psychotic or anti-emetic drug exposure, toxin (CO, Mn, Hg, MPTP, CS2, methanol, cyanide) exposure, multiple head traumas, multiple strokes, or metabolic abnormalities. Prion diseases, especially Creutzfeldt-Jakob and Gerstmann-Straussler-Scheinker disease, present with a more rapid, aggressive course and more profound dementia. Neuroimaging excluded the possibility of hydrocephalus and mass lesions. One might consider the possibility of normal pressure hydrocephalus, consisting of the triad of dementia, gait disturbance, and urinary incontinence. The mild subcortical dementia is consistent with this diagnosis, but the lack of improvement of this patient's leg function on lying down argues against it. Neuroimaging was not consistent with this diagnosis. The Parkinsonism Plus syndromes include an array of neurodegenerative conditions characterized by parkinsonism plus other evidence of neurological dysfunction as seen in our patient. In Diffuse Lewy Body disease, parkinsonism is accompanied by cortical dementia with varying levels of attention, early hallucinations, and psychosis. Autonomic dysfunction is common, and pyramidal signs = may be seen, but cerebellar dysfunction= somatic motor function, the control of muscle tone and the maintenance of balance are not working is not found. This patient's mild subcortical dementia is also not consistent with this diagnosis. In cortical-basal ganglionic degeneration, parkinsonism is accompanied by ideomotor apraxias, = the alien limb phenomenon, = dystonia = extreme muscle cramp resulting in loss of movement with limb in permanent cramp cortical reflex myoclonus, = cortical sensory loss, = marked asymmetry of involvement, =one side of body affected more than the other and focal rigidity = and dystonia == extreme muscle cramp resulting in loss of movement with limb in permanent cramp with contractures. = None of these features was seen in this patient. In progressive supranuclear palsy, parkinsonism is accompanied by a prominent supranuclear gaze disturbance = not seen in this patient. Multisystem atrophy (MSA) is a progressive, = gets worse sporadic = all over the place, unpredictable disorder characterized by parkinsonism in association with varying degrees of cerebellar, = pertaining to loss of somatic motor function, the control of muscle tone and the maintenance of balance pyramidal, = Charlotte had this, can't remember exactly what it was intellectual, = thought processing ability and autonomic dysfunction. = unable to control function which should not require thought (breathing, heart rate, thermoregulation) Classically, this includes three separate entities - Striatonigral degeneration (parkinsonism poorly responsive to levodopa and frequently associated with cervical dystonia), = cervical dystonia = rigid back= rigidity Olivopontocerebellar atrophy (parkinsonism with cerebellar dysfunction), = OPCA = movement, and balance problems and Shy-Drager syndrome (parkinsonism with autonomic dysfunction). = automatic refluxes not working properly i.e. OH, temperature control no good Because of the clinical overlap and common pathologic finding of an intracytoplasmic oligodendroglial inclusion body, = these entities are now lumped together. This patient best fit the diagnosis of multisystem atrophy with evidence of parkinsonism, cerebellar dysfunction, autonomic dysfunction, mild dementia, and long-tract signs. = Geez it can really make your head hurt!

aletta mes vancouver, bc Canada web: http://aletta.0catch.com If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

I have a couple additions and corrections to the below.

Bill! Where did you get "some sort of ivy-shaped nerves"??? LOL ... ok they did misspell the word "hederodegenerative" it's "heredodegenerative".

Heredodegenerative: Pertaining to genetically transmitted (hereditary) neurologic disorders characterized by progressive neuronal loss and other neurodegenerative changes.

I think this is a better definition of Sporadic when referring to a disease:

From Webster's Dictionary: Sporadic disease (Med.), a disease which occurs in single and scattered cases.

progressive pallidal atrophy --> don't know but I'll look it up

Pick's Disease --> that's a frontal lobe dementia

Prion Disease --> I didn't think PD or PD+ disorders really fell under this category... Bill do you have an article about that?

hepatocerebral degeneration --> Don't know that one either.

paraneoplastic --> there are paraneoplastic ataxias... resulting from cancer of the ovary, breast or lung.

A couple new people on the list recently have mentioned "normal pressure hydrocephalus" Note it has similarities to some MSA symptoms --- dementia, gait disturbance, and urinary incontinence. I read it's hard to diagnose.

That's all I have time for today.

Hugs,

Pam

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 1:19 AMTo: shydrager Subject: Re: report from a self-made guinea pig I've added some in black, Bill Werre

Maybe we could have a plain language project among ourselves. Please fill in layman's terms after the '=' The differential diagnosis of parkinsonism accompanied by

atypical features = not normal

is broad and includes the Parkinsonism Plus

syndromes= constellation of symptoms (multisystem atrophies, progressive supranuclear palsy, = PSP cortical-basal ganglionic degeneration, = CBGD progressive pallidal atrophy, diffuse Lewy body disease), = Ken had this - much like MSA Alzheimer's disease with parkinsonian features, Pick's disease, hederodegenerative diseases ('s, Hallervorden-Spatz, Huntington's disease, etc.), and secondary parkinsonism = second to another medical condition, medication or toxin (poisin) (vascular, = to do with blood and it's circulation drug induced, = caused by drugs

infection, = hope we know that

prion disease, = like mad cow disease - actually most Parkinson's Plus disorders fit this description toxins, cadmium would be an example - actually opiates are considered here also trauma, = blow to the head for example mass lesions, = scarring all over (from demyelating disease etc.) hydrocephalus, = water on the brain hypothyroidism, = underfunctioning thyroid paraneoplastic, - pertaining to Hormonal, neurological, haematological, and other clinical and biochemical disturbances associated with malignant neoplasms but not directly related to invasion by the primary tumour or its metastases. hepatocerebral degeneration, and - sorry no clue syringomesencephalia). - ? may be related to problems of the sweat glands Of the various causes, the Parkinsonism Plus syndromes and secondary parkinsonism are the most common. Hederodegenerative diseases are relatively uncommon, and this patient did not fit into any of the recognized patterns of hederodegenerative disease. = some sort of ivy shaped nerves I think The patient's mild subcortical dementia =Relating to the subcortex; beneath the cerebral cortex. and the presence of cerebellar signs =concerned primarily with somatic motor function, the control of muscle tone and the maintenance of balance did not fit the pattern expected for either Alzheimer's or Pick's disease. Infectious possibilities include encephalitis lethargica, = viral brain infection (leeping sickness) HIV, = AIDS syphilis, and SSPE. =Subacute sclerosing panencephalitis = ask a neuro In this case, serologic tests excluded syphilis and HIV infection, and the clinical course and features were not consistent with encephalitis lethargica or SSPE (which are rapidly progressive conditions). There was no history of anti-psychotic or anti-emetic drug exposure, toxin (CO, Mn, Hg, MPTP, CS2, methanol, cyanide) exposure, multiple head traumas, multiple strokes, or metabolic abnormalities. Prion diseases, especially Creutzfeldt-Jakob and Gerstmann-Straussler-Scheinker disease, present with a more rapid, aggressive course and more profound dementia. Neuroimaging excluded the possibility of hydrocephalus and mass lesions. One might consider the possibility of normal pressure hydrocephalus, consisting of the triad of dementia, gait disturbance, and urinary incontinence. The mild subcortical dementia is consistent with this diagnosis, but the lack of improvement of this patient's leg function on lying down argues against it. Neuroimaging was not consistent with this diagnosis. The Parkinsonism Plus syndromes include an array of neurodegenerative conditions characterized by parkinsonism plus other evidence of neurological dysfunction as seen in our patient. In Diffuse Lewy Body disease, parkinsonism is accompanied by cortical dementia with varying levels of attention, early hallucinations, and psychosis. Autonomic dysfunction is common, and pyramidal signs = may be seen, but cerebellar dysfunction= somatic motor function, the control of muscle tone and the maintenance of balance are not working is not found. This patient's mild subcortical dementia is also not consistent with this diagnosis. In cortical-basal ganglionic degeneration, parkinsonism is accompanied by ideomotor apraxias, = the alien limb phenomenon, = dystonia = extreme muscle cramp resulting in loss of movement with limb in permanent cramp cortical reflex myoclonus, = cortical sensory loss, = marked asymmetry of involvement, =one side of body affected more than the other and focal rigidity = and dystonia == extreme muscle cramp resulting in loss of movement with limb in permanent cramp with contractures. = None of these features was seen in this patient. In progressive supranuclear palsy, parkinsonism is accompanied by a prominent supranuclear gaze disturbance = not seen in this patient. Multisystem atrophy (MSA) is a progressive, = gets worse sporadic = all over the place, unpredictable disorder characterized by parkinsonism in association with varying degrees of cerebellar, = pertaining to loss of somatic motor function, the control of muscle tone and the maintenance of balance pyramidal, = Charlotte had this, can't remember exactly what it was intellectual, = thought processing ability and autonomic dysfunction. = unable to control function which should not require thought (breathing, heart rate, thermoregulation) Classically, this includes three separate entities - Striatonigral degeneration (parkinsonism poorly responsive to levodopa and frequently associated with cervical dystonia), = cervical dystonia = rigid back= rigidity Olivopontocerebellar atrophy (parkinsonism with cerebellar dysfunction), = OPCA = movement, and balance problems and Shy-Drager syndrome (parkinsonism with autonomic dysfunction). = automatic refluxes not working properly i.e. OH, temperature control no good Because of the clinical overlap and common pathologic finding of an intracytoplasmic oligodendroglial inclusion body, = these entities are now lumped together. This patient best fit the diagnosis of multisystem atrophy with evidence of parkinsonism, cerebellar dysfunction, autonomic dysfunction, mild dementia, and long-tract signs. = Geez it can really make your head hurt!

aletta mes vancouver, bc Canada web: http://aletta.0catch.com If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

Pam,

hed comes from the latin and means ivy or ivy shaped, we know what degenerative

means and in context of a nerve disorder, I assumed it was spelled correctly.

Therefore I thought of the shape of glial cells and came up with

"ivy shaped nerve cells" ) hedero seemed to be ivy

shaped cancer cells in at least one case - we weren't talking about cancer,

but it seems they were also looking for cancer (brain tumor?) from the

report. Yes I know that assume means to make an ass out of you and

me ) Just the engineering logic taking over )

Bill!

Where did you get "some sort of ivy-shaped nerves"??? LOL ...

ok they did misspell the word "hederodegenerative"

it's "heredodegenerative".

Actually it seemed to me to be a good diagnostic report. I am

not sure I agree with their conclusions as there were no pyramidal or extra-pyramidal

signs which are common in MSA. But they are doctors and did the tests

which gives them much more insight than me as a layman. But they

seemed to do a complete diagnostic workup. I as a layman, would guess

that if this has been going on less than five years it is "possible MSA"

if more than five years "doubtful MSA". Basically they are saying

it is too early to tell what it is.

Take care, Bill

[Guest guest]

That's too funny! Still ROTLFMAO

xox

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 10:33 AMTo: shydrager Subject: Re: report from a self-made guinea pigPam, hed comes from the latin and means ivy or ivy shaped, we know what degenerative means and in context of a nerve disorder, I assumed it was spelled correctly. Therefore I thought of the shape of glial cells and came up with "ivy shaped nerve cells" ) hedero seemed to be ivy shaped cancer cells in at least one case - we weren't talking about cancer, but it seems they were also looking for cancer (brain tumor?) from the report. Yes I know that assume means to make an ass out of you and me ) Just the engineering logic taking over ) Bill! Where did you get "some sort of ivy-shaped nerves"??? LOL ... ok they did misspell the word "hederodegenerative" it's "heredodegenerative". Actually it seemed to me to be a good diagnostic report. I am not sure I agree with their conclusions as there were no pyramidal or extra-pyramidal signs which are common in MSA. But they are doctors and did the tests which gives them much more insight than me as a layman. But they seemed to do a complete diagnostic workup. I as a layman, would guess that if this has been going on less than five years it is "possible MSA" if more than five years "doubtful MSA". Basically they are saying it is too early to tell what it is. Take care, Bill If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

Pam,

The definition of "assume" or my logic in working out a definition of

the ivy shaped cells ) Which has you rolling on the floor and what

is MAO - sounds erotic ) Wait until I send some of Anne's pictures.

I told her she had to sit on my lap as she had sat on Fordy's lap when

he was there. We also got her to sit in the wheelchair to go to the

wildlife preserve - note it took two strong men to keep her there - you

don't see the rope we had her tied in with )

We need a little laughter, things were getting too serious on the list.

Where are Carol Lee, and Relles with their jokes.

Take care and koala hugs back, Bill Werre

-------------------------------------------------------

Pam Bower wrote:

That's

too funny! Still ROTLFMAO xox

[Guest guest]

Pam,

The definition of "assume" or my logic in working out a definition of

the ivy shaped cells ) Which has you rolling on the floor and what

is MAO - sounds erotic ) Wait until I send some of Anne's pictures.

I told her she had to sit on my lap as she had sat on Fordy's lap when

he was there. We also got her to sit in the wheelchair to go to the

wildlife preserve - note it took two strong men to keep her there - you

don't see the rope we had her tied in with )

We need a little laughter, things were getting too serious on the list.

Where are Carol Lee, and Relles with their jokes.

Take care and koala hugs back, Bill Werre

-------------------------------------------------------

Pam Bower wrote:

That's

too funny! Still ROTLFMAO xox

[Guest guest]

ROTFLMAO = Rolling on the floor laughing MY ASS OFF! The "assume" definition I'd heard before... I'm still laughing about "hederodegenerative ivy-shaped nerve cells". Can someone draw me a picture of those? I'm going to propose a study and get funding from the NIH. LOL!

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 11:42 AMTo: shydrager Subject: Re: report from a self-made guinea pigPam, The definition of "assume" or my logic in working out a definition of the ivy shaped cells ) Which has you rolling on the floor and what is MAO - sounds erotic ) Wait until I send some of Anne's pictures. I told her she had to sit on my lap as she had sat on Fordy's lap when he was there. We also got her to sit in the wheelchair to go to the wildlife preserve - note it took two strong men to keep her there - you don't see the rope we had her tied in with ) We need a little laughter, things were getting too serious on the list. Where are Carol Lee, and Relles with their jokes. Take care and koala hugs back, Bill Werre ------------------------------------------------------- Pam Bower wrote: That's too funny! Still ROTLFMAO xox

[Guest guest]

Pam Bower wrote:

I'm still laughing about "hederodegenerative ivy-shaped nerve cells".

Can someone draw me a picture of those?

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This is what I saw in the microscope at a million X magnification,

Pam

Hugs Bill

[Guest guest]

It seems that I recall that hedera is a type of ivy plant--but I can't

find the word in my dictionary. MLReynoldsAt 09:33 AM 5/29/2002

-0400, you wrote:

Pam,

hed comes from the latin and means ivy or ivy shaped, we know what

degenerative means and in context of a nerve disorder, I assumed it was

spelled correctly. Therefore I thought of the shape of glial

cells and came up with " ivy shaped nerve cells "

) hedero seemed to be ivy shaped cancer cells in at least

one case - we weren't talking about cancer, but it seems they were also

looking for cancer (brain tumor?) from the report. Yes I know that

assume means to make an ass out of you and me ) Just the

engineering logic taking over )

Bill! Where did you get

" some sort of ivy-shaped nerves " ??? LOL ... ok they

did misspell the word

" hederodegenerative "

it's " heredodegenerative " .

Actually it seemed to me to be a good diagnostic report. I am not

sure I agree with their conclusions as there were no pyramidal or

extra-pyramidal signs which are common in MSA. But they are doctors

and did the tests which gives them much more insight than me as a

layman. But they seemed to do a complete diagnostic workup. I

as a layman, would guess that if this has been going on less than five

years it is " possible MSA " if more than five years

" doubtful MSA " . Basically they are saying it is too early

to tell what it is.

Take care, Bill

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[Guest guest]

Greetings Bill,

Sorry to disagree on one point. Sporadic when used as a medical term for a disease means that there is no familial history. I modified the definition.

Aletta, this is a great idea. Something that should be a good resource for all of us. Thanks.

Regards,

=jbf=

B. Fisher

-----Original Message-----From: Werre Sent: Wednesday, May 29, 2002 12:19 AMTo: shydrager Subject: Re: report from a self-made guinea pig I've added some in black, Bill Werre

Maybe we could have a plain language project among ourselves. Please fill in layman's terms after the '=' The differential diagnosis of parkinsonism accompanied by

atypical features = not normal

is broad and includes the Parkinsonism Plus

syndromes= constellation of symptoms (multisystem atrophies, progressive supranuclear palsy, = PSP cortical-basal ganglionic degeneration, = CBGD progressive pallidal atrophy, diffuse Lewy body disease), = Ken had this - much like MSA Alzheimer's disease with parkinsonian features, Pick's disease, hederodegenerative diseases ('s, Hallervorden-Spatz, Huntington's disease, etc.), and secondary parkinsonism = second to another medical condition, medication or toxin (poisin) (vascular, = to do with blood and it's circulation drug induced, = caused by drugs

infection, = hope we know that

prion disease, = like mad cow disease - actually most Parkinson's Plus disorders fit this description toxins, cadmium would be an example - actually opiates are considered here also trauma, = blow to the head for example mass lesions, = scarring all over (from demyelating disease etc.) hydrocephalus, = water on the brain hypothyroidism, = underfunctioning thyroid paraneoplastic, - pertaining to Hormonal, neurological, haematological, and other clinical and biochemical disturbances associated with malignant neoplasms but not directly related to invasion by the primary tumour or its metastases. hepatocerebral degeneration, and - sorry no clue syringomesencephalia). - ? may be related to problems of the sweat glands Of the various causes, the Parkinsonism Plus syndromes and secondary parkinsonism are the most common. Hederodegenerative diseases are relatively uncommon, and this patient did not fit into any of the recognized patterns of hederodegenerative disease. = some sort of ivy shaped nerves I think The patient's mild subcortical dementia =Relating to the subcortex; beneath the cerebral cortex. and the presence of cerebellar signs =concerned primarily with somatic motor function, the control of muscle tone and the maintenance of balance did not fit the pattern expected for either Alzheimer's or Pick's disease. Infectious possibilities include encephalitis lethargica, = viral brain infection (leeping sickness) HIV, = AIDS syphilis, and SSPE. =Subacute sclerosing panencephalitis = ask a neuro In this case, serologic tests excluded syphilis and HIV infection, and the clinical course and features were not consistent with encephalitis lethargica or SSPE (which are rapidly progressive conditions). There was no history of anti-psychotic or anti-emetic drug exposure, toxin (CO, Mn, Hg, MPTP, CS2, methanol, cyanide) exposure, multiple head traumas, multiple strokes, or metabolic abnormalities. Prion diseases, especially Creutzfeldt-Jakob and Gerstmann-Straussler-Scheinker disease, present with a more rapid, aggressive course and more profound dementia. Neuroimaging excluded the possibility of hydrocephalus and mass lesions. One might consider the possibility of normal pressure hydrocephalus, consisting of the triad of dementia, gait disturbance, and urinary incontinence. The mild subcortical dementia is consistent with this diagnosis, but the lack of improvement of this patient's leg function on lying down argues against it. Neuroimaging was not consistent with this diagnosis. The Parkinsonism Plus syndromes include an array of neurodegenerative conditions characterized by parkinsonism plus other evidence of neurological dysfunction as seen in our patient. In Diffuse Lewy Body disease, parkinsonism is accompanied by cortical dementia with varying levels of attention, early hallucinations, and psychosis. Autonomic dysfunction is common, and pyramidal signs = may be seen, but cerebellar dysfunction= somatic motor function, the control of muscle tone and the maintenance of balance are not working is not found. This patient's mild subcortical dementia is also not consistent with this diagnosis. In cortical-basal ganglionic degeneration, parkinsonism is accompanied by ideomotor apraxias, = the alien limb phenomenon, = dystonia = extreme muscle cramp resulting in loss of movement with limb in permanent cramp cortical reflex myoclonus, = cortical sensory loss, = marked asymmetry of involvement, =one side of body affected more than the other and focal rigidity = and dystonia == extreme muscle cramp resulting in loss of movement with limb in permanent cramp with contractures. = None of these features was seen in this patient. In progressive supranuclear palsy, parkinsonism is accompanied by a prominent supranuclear gaze disturbance = not seen in this patient. Multisystem atrophy (MSA) is a progressive, = gets worse sporadic = no family history of a disease disorder characterized by parkinsonism in association with varying degrees of cerebellar, = pertaining to loss of somatic motor function, the control of muscle tone and the maintenance of balance pyramidal, = Charlotte had this, can't remember exactly what it was intellectual, = thought processing ability and autonomic dysfunction. = unable to control function which should not require thought (breathing, heart rate, thermoregulation) Classically, this includes three separate entities - Striatonigral degeneration (parkinsonism poorly responsive to levodopa and frequently associated with cervical dystonia), = cervical dystonia = rigid back= rigidity Olivopontocerebellar atrophy (parkinsonism with cerebellar dysfunction), = OPCA = movement, visual and balance problems and Shy-Drager syndrome (parkinsonism with autonomic dysfunction). = automatic refluxes not working properly i.e. OH, temperature control no good Because of the clinical overlap and common pathologic finding of an intracytoplasmic oligodendroglial inclusion body, = these entities are now lumped together. This patient best fit the diagnosis of multisystem atrophy with evidence of parkinsonism, cerebellar dysfunction, autonomic dysfunction, mild dementia, and long-tract signs. = Geez it can really make your head hurt!

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