Tuesday, March 12, 2013

PARKINSON'S DISEASE

PARKINSON’S DISEASE (PD)

What is Parkinson’s disease (PD)?
Parkinson’s disease is a disease of the brain, which is caused by selective degeneration of nerves in the basal ganglia, leading to deficiency of dopamine in brain.

What are the symptoms of Parkinson’s disease?
The most typical symptoms of this disease include:
  1. Tremors- shaking of hands and feet,
  2. Slowness of all activities,
  3. Stiffness of arms and legs,
  4. Loss of balance while standing or walking.
A patient may have only one or some or all of these at onset. However, as the disease progresses, all of them would eventually develop all these symptoms.

What are some of the other symptoms of Parkinson’s disease?
Other symptoms that may occur in a patient with Parkinson’s disease are:
  1. Mask-like facies or expressionless face, (even in situations of happiness, they may fail to express it on the face),
  2. Stooped posture, with head & trunk bent forwards,
  3. Slurred and low volume speech (it is often difficult to comprehend what they are saying),
  4. Slow speed of walking,
  5. Reduced swinging of arms while walking,
  6. Very small letters while writing, referred to as Micrographia,
  7. Reduced blink rate (which makes them give a staring look),
  8. Short, shuffling steps while walking,
  9. Loss of balance while turning, leading to falling forwards.
Why this disease is called Parkinson’s disease?
This is because the very first description of this disease was given by a doctor named Dr James Parkinson, a neurologist from UK. In his honour, the disease was given his name.

Which age group is commonly affected with Parkinson’s disease?
This disease typically affects people above 40 years of age, and the incidence increases with advancing age.
Occasionally, this can occur in people younger than 40, when it is called young onset Parkinson’s disease (YOPD).

How is Parkinson’s disease diagnosed?
Like many other neurological problem, Parkinson’s disease too is diagnosed on the basis of typical symptoms (as described above).
It may be difficult to diagnose PD in very early stages, as the affected person may have only minor symptoms such as mild tremors of hands, and perfectly well otherwise. However, careful examination by a Neurologist would help confirm its diagnosis in this stage too.

Is there a very specific test for diagnosing Parkinson’s disease, especially in early stage?
In doubtful cases, or in very early stages, PET scan (positron emission tomography) can help in accurate diagnosis of PD. This facility is available in our hospital, and I do use it in some cases.

Can Parkinson's disease be transmitted genetically to the children of patients suffering from this disease?

In about 10% of cases, PD can be genetic in origin. But about 90% of cases of PD are sporadic (they have no family history of Parkinson's disease).

What are the treatment options available for Parkinson’s disease?
The mainstay of treatment of PD is medications. Various medications are available. These include levodopa/carbidopa combination (which provide direct dopamine to the brain); ropinirole & pramipexole (which increase the action of dopamine); trihexiphenidyl, amantadine, entacapone, etc.
The choice of drug depends on the patient’s symptoms as well as the severity & duration of PD.
Your neurologist is the best person to decide the most appropriate medications and their doses.

What are the common side effects with medications used for treating PD?
Though these medications are generally safe, some side effects may occur:
  1. Giddiness while sitting up or standing- this is because of drop in BP while standing, which is a side effect of levodopa/carbidopa (syndopa/sinemet),
  2. Behavioural disturbances- agitation, hallucinations (seeing something that is not there or hearing something when no one is speaking, etc), sleep disturbances can occur with syndopa, especially if the last dose is taken late (such as after 8 pm). 
  3. Nausea, vomiting, loss of appetite may occur with syndopa.
  4. Abnormal movements of hands or feet, akin to dancing or rhythmic movements, referred to as dyskinesias.
What are the common precautions while taking medications for PD?
1. Medications for PD should be taken on empty stomach, as presence of food may interfere with their absorption,
2. They should be taken on exact time, as advised by the doctor,
3. Any change in the dosage or timing of the medications should be done only after consulting the neurologist.

How long are the medications required in Parkinson’s disease?
Medications are usually required for lifelong. However, the dose would change as per the severity of disease.

Are botulinum toxin injections (Botox) helpful in treating PD?
In selected cases, where there is increased rigidity or dystonia, botox may be useful. The decision can be made by the neurologist after clinical examination.

Are there any surgeries available for treating Parkinson’s disease?
Deep brain stimulation (DBS) surgery is the standard surgery performed in some cases of PD. This surgery can be compared to pacemaker (of heart); wherein an electrode is placed in the brain.
It should be noted that not all cases of PD require surgery, nor would all cases of PD benefit from DBS surgery.
Patients with predominant tremors of hands may be the best candidates for DBS surgery.
Another group of patients who may benefit are those with inadequate response to levodopa, or those with levodopa-induced dyskinesias (see above under side effects).
The decision regarding the need or usefulness of surgery can be made by the neurologist after detailed clinical evaluation.

Is DBS surgery available in India?
Yes, many centers in India (Mumbai, Bangalore, New Delhi, Hyderabad, Trivandrum, etc) have the facilities for doing DBS surgery in India.
We perform DBS surgery in our institute too.

What kind of outcome can be expected in patients with PD after treatment?
  1. There is no cure available for PD,
  2. Disease continues to progress despite medical treatment, and the severity of disease would worsen over time,
  3. The disease leads to severe motor disability, hampering the activities of daily living and occupation,
  4. There is generally no increase in the chances of death, if the patients are looked after well.
  5. However, it should be noted that a reasonably good quality of life can be maintained with proper medical treatment and physiotherapy for more than 20 years after the onset of PD symptoms.
Is there a specific diet to be followed by patients suffering from Parkinson’s disease?
Protein content should be reduced by 50%, and protein-rich foods (such as pulses, meat, etc) should be shifted to dinner time (after the last dose of syndopa has been taken). This is to ensure proper absorption of syndopa, as presence of high protein food may interfere with the absorption of levodopa.

Is there any limitation on physical activities?
No, there is none. In fact, it is better for a patient with PD to indulge in regular physical activities, including outdoor games, to maintain good physical fitness & mobility.

If you have any additional queries on Parkinson's disease, please send me an email: drsudhirkumar@yahoo.com

DR SUDHIR KUMAR MD (Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Health City, Hyderabad, India
Phone: 0091-40-23607777


94 comments:

Anonymous said...

Sir, is there any genetic test for P.D. available in mumbai or any other court in India?

Dr. Sudhir Kumar said...

Parkinson's disease can be genetic in about 10% of cases. This genetic testing is usually done in research and I do not advise it to be done in routine clinical practice in India.
Best wishes,
Dr Sudhir Kumar MD DM

Anonymous said...

Sir, how about autonomic function test as a diagnostic method for PD, is there sleep disorder also associated with PD ??

NANS JOSEPH said...

sir
which is the best hospital in india for the treatment of P.D

Dr. Sudhir Kumar said...

Hi Nans Joseph,

There are several good neurologists for treatment of PD in India. These include neurologists at Apollo Hospital, Hyderabad, NIMS Hyderabad, Jaslok Mumbai, NIMHANS, Bangalore and Sree Chitra Trivandrum

Dr Sudhir Kumar

SHIVAJI said...

Hi Sir! My name is Shivaji, am 33years old, am a fits patient from the past 15years, am married, will this disease continue to my children?

Arshad Mohammed said...

My Father aged 68yrs is suffering from momentary disorders,hallucinations etc since 2 years.doctors indicated sympoms of parkinsons or LBD.He is taking syndopa and other medicines since then, but his conditions have gone very critical as he is having hallucinations very often.Kindly give me a suitable appointment date for visiting in OPD.
Please give the address of the hospital as i am new in the city
Thanking you in anticipation
Arshad
9949502734

Ashish Kumar said...

Sir, my name is Ashish and my father's health is not good. Doctor of Apollo hospital, Delhi says that he is suffering from parkinsons plus psp so please suggest me a best neurologist in Delhi or near Delhi........thanks

Ashish Kumar said...

Sir who is the best neurologist for parkinsons plus psp in north india

Ashutosh Gupta said...

sir pl tell me any best docter in bihar for pd

Anonymous said...

Sir ,

My Father aged 73 years is showing symptoms of parkinsons. We are from Mumbai . Please advise a Specialist in Central Mumbai .

Anonymous said...

Sir ,
Does Parkinsons cause stifness of back ?

IH

Anonymous said...

my brother-in-law suffering with Parkinson"s disease since last two years, age 67 years. he is having hypertension and diabetic since last 5 years now BP and sugar are in control. the medications used are syndopa dosage 3 tablets ,piramprex 0.50 2 tablets per day .but symptoms are existing such as hallucination,abnormal behavior ,sleepless ness etc. kindly suggest and direct us proper dimension.

Dr. Sudhir Kumar said...

I would be pleased to see your father at Apollo Hospitals, Hyderabad to sort out the treatment.

Dr Sudhir Kumar

Anonymous said...

My father is suffering from PD(with all symptoms) from 5 years along with hyperthyroidism. Sugar is normal. From last 2 months complaining high BP. He is taking syndropa, ropark. Pls suggest should we go for DBS and how much cost would incurred by DBS. Pls help.

dev sharma said...

Dear Sir,
I m from Bhilwara Rajasthan. My father is suffering from Parkinson. He is taking Ropark and Syndropa plus regularly. but now a days his hands are shaking at higher pace. cant stand on his feet properly. Can u suggest best hospital in North and ur opinion about these medicines.

Anonymous said...

SIR my sister is only 37 yr old & had PD,recommend good doctor in Delhi


Dr. Sudhir Kumar said...

You could consult Dr Sumit Singh at Medanta Gurgaon, or Dr Madhuri Behari at AIIMS, or Dr Vinit Suri at Apollo Delhi.

Dr Sudhir Kumar MD DM

Rahul Agarawal said...

Please suggest me good doctor to consult in Hyderabad for my father (age : 65) suffering from PD.

Also, I heard about eating/drinking aids available to help people suffering from PD. Are they really proven and reliable solution ?

Thanks!!
Rahul

Dr. Sudhir Kumar said...

Hi Mr Rahul,

Thank you. I would be pleased to see your father with PD and advise the best medical treatment. I am available at Apollo Hospitals, Jubilee Hills, Hyderabad daily, for consultation.

Anonymous said...

Sir my name is savitha.my father from one week.he became so silent and oftenly his hands gets straight.it has no strength.after 10or20 it become normal and he cant speak properly.we have to Tel him twice or thrice then he will try to reply.please answer me sir y it is happening.we very scared.we don't have moral support. Accept him

Anonymous said...

Hi Doctor ,

My mother is suffering from PD from past 2 years ,inadditon to that she has high BP and is also a diabetic patient ,she is currently 70+,I am residing in bangalore currently ,could you suggest any good doctors here in bangalore for her treatment.

Thanks in advance

Anonymous said...

Sir, My father is given parkinsons medicines by a senior doctor.But once the daosage is increased like ropark 6mg/day, rasalect and pramiprex, his condition deteorated badly.Another doctor ruled out parkinsons and gave him Spinfree, with which he is much much better.iam unable decide

Aarti said...

sir my father aged 53 years is suffering from parkinsons plus so
is their any operation for parkinsons plus in india?
pls reply

Anonymous said...

Hi Doctor ,

not sure if you are checking our messages ,we all are eagerly waiting for your reply

Dr. Sudhir Kumar said...

For Parkinson's plus, there is no operation. For Parkinson's disease, deep brain stimulation (DBS) operation is available in India.

Dr. Sudhir Kumar said...

In Bangalore, You can meet Dr Murali Srinivas at Manipal hospital.

nilesh sakariya said...

sir my father suffering with parkinson's disease (PSP) since a last 4 year,age 55,so is their any treatment for PSP. please suggest me good doctor to consult in gujarat.

nilesh sakariya said...

sir my father suffering with parkinson's disease(PSP) since a last 4 year,age 55 year.so is their any treatment for PSP.please suggest me good doctor to consult in gujarat

Anonymous said...

hello doctor..my father 58 unable to walk properly and looses balance while walking and standing.. also there is little slurring in speech..in MRI report it is written that there is mild diffuse cerebral atoropy..and our doctor said this is the symptoms of parkinson.. i am confusing ..please suggest best doctor in chandigarh or delhi..
thanks

abhishek jain said...

Hiii sir ,
My dady is suffering from PD , from last 2 years , can u give me some suggestion .

Anonymous said...

Sir my elder bro left hand and leg is not working properly. He is going under treatment in cmc vellore but medicine is not working now they are going to conduct a test related to Parkinson which is conducted only in Mumbai . Sir , which type of test is this

Rezaul karim said...

sir my country is bangladesh. my father is 66.he is a he is attack in perkinsons dieases.I taken indian visa.please inform me where I will come and which docter is best for my father

Anonymous said...

Hi sir,
I read your Q &A article on Parkinson's disease and am very gla I did beause it is very inspiring. I wanted to ask u if there is any way we can 50% treat the Parkinson's disease?

Anonymous said...

Hello Doctor
My mother in law is suffering from Parkinson's since last 5 yrs . Can you suggest best doctor in mumbai for this..

neelesh fondekar said...

Kindly suggest good doctor in Mumbai to treat parkinson desease@72yrs old man treatment

Sachin Sood said...

Hi
Could you tell me basic PD basic symptoms, how can i found this illness
Parkinson’s specialist in Delhi

himanshu bhatia said...

Kindly suggest good doctor in Delhi to treat parkinson disease@65yrs old man treatment

Richa Chandra said...

Hello Doctor,

My mother (50 years) is suffering from PD, since last 10 years. The medication included syndropa, but soon there were many side effects - majorly hallucinations and involuntary body movements. We tried opting for an Ayurvedic alternative (Jhandopa), but soon the side effects reappeared, majorly hallucinations (seeing people who are not there, listening voices which are not there). This is causing a very bad impact on her mental health also.

Please suggest, if there is a medication available to curb the side effects? We shall be available, to meet you at Hyderabad as well.

Anonymous said...

I am 44 years old. Since last week I am having minor tremors in my Thumb. I have sleep problem since last 2-3 years. I have to eat Alprex to sleep. My mother is a Parkinson patient. She developed Parkinson at the age of 53. Now she is 66. Should I go for a check up for Young Parkinson examination ?

binny said...

Sir
Kindly suggest doctor in Odisha for Parkinson disease. My father is suffering.

aks040881 said...

Hi Dr ,

My father has been taking Syndopa since 3 years ,
However PD symptoms have come back like sever body pain, lack of movement, unsinsomnia , rapid breathing . I guess his dosage needs to be adjusted please suggest a good doctor in Mumbai.

narendra singh said...

hello sir good morning sir my daughter km akshra tomar age 06 years was suffering from complex partial seizure since october 2013 at present her treatment is contuning from PGI Chandigarh but no any improvement in her healt. doctors giving selzic-300 continue from 1 years but no any improvment in her health. please suggest me for best doctor/hospital/medicine for better treatment of my daughter please si. i am highly obliged to you for this act of kindness. my self narendra sing

Adorable1199 said...

am suffering with bipolar disorder with psychotic depression and i have had eplipsy history as well.
I have had brain injury also.

Unknown said...

Hello Dr Sudhir Kumar,

My father is suffering from PD for 7 years, he is taking medicine, but day by day his condition is getting worse. I would like to bring him for a consultation with a experienced doctor like you. I live in south of Tamilnadu. Do you work in Apollo or any clinic in chennai? Or can you suggest anyone in chennai who is really good in Neurology and movement disorder ??

Thanks .
Vijay

Unknown said...

Hello Sir,

My father has Pd for 7 years, and he lives in south tamil nadu. Do you know of any movement disorder specialist in Apollo chennai? Any suggestion of doctor or clinic in chennai for PD? i believe you don't work in chennai.

Sachi Otia said...

Hi Dr. Sudhir can you pls suggest the good neuro surgeon for PD? my mother in law is suffering from this disease since last more than 10 years now.she is very much strong mentally.currently she is under treatment of Dr. Buch from Vadodara.

DAR SAKIB said...

Hey sir my mom is suffering from this disease for many years...but there is no relife..even the condition is worsen day by day...sir please suggest me any neurologist in north india...I m from jammu n kashmir

Shiva Lingaiah said...

Hi sir .. appolo JH hills is far away to my place. Do you have any other place of visit to meet you other than APPOLO

Shivam maffia said...

Sir my father is suffering from parkison and i take him to Nibhans hospital bangolore to treat him but the doctor says there is no treatment for only medicine and nice environment will cure him and they said that he is suffering from MSA (MULTIPLE SYSTEM ATROPHY) sir can you tell me there is a hope for my father

ramesh pingali said...

sir,
i have hypothyroid with a tsh reading of 17.8(earlier reading in aug 2015 was 7.5). i will be taking thyroxine 50 mg from tomorrow. i am on a maintenance dose of one tab a month for vitamin d deficiency.in dec2015 i consulted a sr. neurologist in vizag and the diagnosis was bradykinesia. the doctor put me on raselect 1 mg one per day. this symptom is present only when i walk at a leisurely pace. i am able to walk at a very brisk pace without any discomfiture. symptoms are also fluctuating--at times i wear my slippers with utmost ease.there are occasions when this task becomes difficult. i am referring to my right leg which is effected. similarly i can perform some actions with my right arm very easily, while some actions require a lot of effort. the doctor as of now has not confirmed PD.is there any way out ?

Unknown said...

Hello Doctor,my uncle is suffering from PD,it's his 5th year with the disease and it's getting worse. We live in pune and seek your guidance and reference on who to consult in oder to help him get better. Please help,we Await yr answer in great anticipation.

mayra said...

Sir, please suggest the best doctor for PD in Chandigarh, he has started to visually hallucinate with medication. Earlier he had sleep disorders but they were resolved as per us. Now PD is taking toll on his activities. Please help. Thanks!!

Dr. Sudhir Kumar said...

Mayra, you could consult neurologist at PGI, Chnadigarh

Dr. Sudhir Kumar said...

At Pune, you could consult Dr Sudhir Kothari or Dr Ichhaporia

Dr. Sudhir Kumar said...

Mr Ramesh Pingali, I would be pleased to evaluate you at Apollo Hospital, Hyderabad and advise the best medical treatment.

Dr. Sudhir Kumar said...

Mr Shivam Maafia, there is no cure for MSA. Physiotherapy may help a little bit.

ramesh babu arisha said...

Hi Sir,

can you pls suggest the good neuro surgeon for PD in chennai apollo.

Ajaya Kumar Nayak Rayagada said...

Sir, My father is 49 years old and he is suffering from Parkinson's disease since last 2 years. Would you please suggest me the best doctor for treatment in visakhapatnam

Jasmeet singh said...

Hi sir, my father living in ludhiana is taking medication of Parkinson disease from last 7 years and is now suffering from low BP, constipation,depression And hallucinations. Through he has been taking medication for the above he has lost weight and his health is deteriorating..request you to guide how to proceed with the treatment

Jasmeet singh said...

Hi sir, my father living in Ludhiana Punjab is suffering from Parkinson from last 16 years.. He is taking syndopa but now he is also suffering from hallucinations, low BP , constipation and depression. He is taking medicines for the above but all intake of so many medicines is taking a toll on his health and he has lost lot of weight.. Request you to guide how to proceed further in his condition.

Dr. Sudhir Kumar said...

Jasmeet Singh, if possible to come to Hyderabad, I would be pleased to see your father and advise accordingly. However, in Ludhiana, you can consult Prof Jeyaraj Pandian at CMC Ludhiana.

Varun Kuncha said...

hi sir my ame is varun i'm from vizianagaram my father is 39 years old and he is suffernig with with parkinsonism i think it is in starting stage and my father is suffering with backpain too now he is using the followig talets
syndopa plus- 4 per a day(mrng,afternoon,evng,nd night)
parkitidin-(mrng,,night, evng )
pacitine-(3 times a day)(half)
ropark(mrng,evng)
and is there any cure for this sir plz suggest me.......kindly

Varun Kuncha said...

hi sir my ame is varun i'm from vizianagaram my father is 39 years old and he is suffernig with with parkinsonism i think it is in starting stage and my father is suffering with backpain too now he is using the followig talets
syndopa plus- 4 per a day(mrng,afternoon,evng,nd night)
parkitidin-(mrng,,night, evng )
pacitine-(3 times a day)(half)
ropark(mrng,evng)
and is there any cure for this sir plz suggest me.......kindly

Anonymous said...

hi sir my ame is varun i'm from vizianagaram my father is 39 years old and he is suffernig with with parkinsonism i think it is in starting stage and my father is suffering with backpain too now he is using the followig talets
syndopa plus- 4 per a day(mrng,afternoon,evng,nd night)
parkitidin-(mrng,,night, evng )
pacitine-(3 times a day)(half)
ropark(mrng,evng)
and is there any cure for this sir plz suggest me.......kindly

Dr. Sudhir Kumar said...

Hi Varun, I have noted your father's symptoms. There are good medicines for Parkinson's disease, with which we can control his symptoms, however, no cure is possible. Back pain is unrelated and needs to be investigated.

Anonymous said...

Hello Sir, my mom was diagnosed with pd 1.5 yrs back. Twice once in dec'15 and now in July '16 after starting physio her symptoms have worsened( due to which physio stopped and meds increased).She does not have tremors but slowness and rigidity as her main symptoms. In addition she also had mild Herpes zoster in July. Now in spite of increasing meds she is no better, has to use a walker and cannot do any tasks herself. She has developed camptocormia and has severe forward and some side lean. I feel her diagnosis may not be pd but some atypical Parkinson's like SMS...how can pd progress so fast. Also I read in some cases Dopamine agonist can cause camptocormia as a side effect..she is on pramipex. I am really worried..our neurologist is not very open and communicative..and seems to suggest this can happen in pd and to start physio. I am not convinced. Plus starting physio seems scary due to her past bad experience. Don't know what to do... seeing my mom being disabled and deformed posturally.

Shyam Kumar said...

Hi sir my name is shyam from uppal hyd my mother is suffering with PD since 3 year, know we are using table like syndopa 110 and also syndopa cr but it is not working at all.. in mrng patient brain catchs tightly and shakes and she does not to each other on that time she can not do own work plz suggest me how to over come from this PD disease

Anonymous said...

Hi sir my name is shyam from uppal hyd my mother is suffering with PD since 3 year, know we are using table like syndopa 110 and also syndopa cr but it is not working at all.. in mrng patient brain catchs tightly and shakes and she does not to each other on that time she can not do own work plz suggest me how to over come from this PD disease

Dr. Sudhir Kumar said...

Hi Shyam. I request you to bring your mother to Apollo hospital, Jubilee Hills, for check up. I can advise the best medical treatment.

Unknown said...

Sir can u suggest any specialist in mumbai for this parkinson diseas pls reply
Thank u

Imran Siddiqui said...

Sir can u suggest a experienced doctor in mumbai for this parkinson diseas as my father is suffering with this since 10 years

Dr. Sudhir Kumar said...

Hi Imran, You can consult Dr Charulata Sankhla at Hinduja hospital; or Dr Mohit Bhatt at Kokilaben hospital, both of whom are experienced in treating Parkinson's disease.

Amit said...

Dear Dr Sudhir,
My father who himself is a doctor is suffering from PD since last 8 years. Since last 3-4 years he is under treatment of Dr Mohit Bhatt. After starting the treatment with Dr Mohit conditions improved a lot but since last few months he is facing some more stiffens and feeling problem in walking. As he himself is a doctor, he thinks for various consequences and gets depressed which aggrevate the disease. We get the doses regulated by Dr Mohit at least 2-3 times per year but want to see some experts in Hyderabad as well. All drugs do not suit him, he is on Syndopa and Pramipex since last 4 years along with exercises. My father has a doubt that drug will become resistant in 3-4 years which increases the fear.
I wanted to know about the longevity with walking and self control in this disease.
Pls suggest. Which place you will be available on Saturday.

Dr. Sudhir Kumar said...

Hi Amit, thanks for posting about your father. I consult at Apollo Hospital, Jubilee Hills, Hyderabad on all days, including Saturday (12 noon to 5 Pm).

uhcstaffing said...

thanks for sharing information. it is a very helpful information. such as a great information.

Anonymous said...

Dear Dr. Sudhir Kumar,

I have Parinsonism for almost 3 years. For the first 2 years I was on Rasalect and lately on Syndopa Plus as well.

I am slightly puzzled to read that medicines are to be taken on empty stomach i.e. before meals. All this while, I have been taking AFTER meals. The sequence of my medication is as given below.

1.1 Morning waking up - Pentocid DSR
1.2 30 minutes later - breakfast
1.3 Immediately after breakfast - Syndopa CR + Rasalect 0.5 + Losar 50
1.4 Lunch
1.5 Afternoon tea
1.6 Dinner
1.7 Immediately after dinner - Syndopa CR + Rasalect 0.5 + Xet CR Plus 12.5

My questions are -
a. Does this sequence need to be modified?
b. In addition to maintaining a 30 minutes gap, should I adhere to specfic timings too? Say 8.00 am breakfast (and then Syndopa and Rasect) and 8.00 pm dinner (and then Syndopa and Rasect)?
c. Can the degeneration be halted or atleast slowed down?
d. Should I ask my doctor to refer to a relevant physiotherapist?

Regards
Karun T

Dr. Sudhir Kumar said...

Hi Karun, Thank you for reading the article. You have very specific questions, which can be answered after examining you. If interested, I am willing to see you. Otherwise, you can discuss these issues with your current neurologist.

Kailash Chand said...

Dear Sir,

My mother aged 77 years is suffering from PD. She is taking Syndopa 275 mg thrice a day. But whenever she takes this medicine, she vomits and she has a problem of nausea also. Could you please tell me Best Neurologist available in Delhi/New Delhi. It is urgent please as my mother is not able to move also on her own. Please Sir, help me. Regards, Kailash 09350427898

Dr. Sudhir Kumar said...

Dear Mr Kailash, at Delhi, you can consult Dr Vinit Suri (Apollo Hospital, New Delhi) or Dr C S Aggarwal at Ganga Ram Hospital.

Anonymous said...

Respected sir,
I am male aged 24. My father suffered from PD ( now no more). His younger sister too suffering from PD ( now chronic and bedridden ). My father's 3 brothers and 4 sisters are not affected from PD. I am an athlete and will be busy with sports and office work. Is it hereditary ? I am the only son of my father. Whether I can get married and lead happy married life? Now-a - days I am getting more worried about it. Please guide.

Dr. Sudhir Kumar said...

Parkinson's disease is not hereditary in most cases (only about 10% of cases can be genetic).

Unknown said...

Hello sir...
Mere father ko roght hand me shivring h..
Unko last ek year se shivring aa rhi h..kbhi kbhi toh hand apne aap ruk jata h.. or apne aap hilne lag jata h... please tell us any solution...

Dr. Sudhir Kumar said...

Dear Unknown, please get your father checked up by a neurologist, to determine if he has Parkinson's disease or not. Then, appropriate medicines can be started.

gaurav arora said...

Dear Dr.sudhir,
Is stem cell therapy a good option for a patient suffering from pd?

Dr. Sudhir Kumar said...

Dear Mr Gaurav,

Stem cell therapy is still under investigation in patients for PD. So, as of now, we should not use it in patients (until FDA approves it).

Unknown said...

Sir plz tell me about Exelon patch medicine that is Available in 5 cm 10 cm 15 cm. Is it fruitful for parkinson patients or not...
1. Syndopa plus 4 times
2. Rasagiline 1mg
3.Amantrel 100mg 2 times
4.Clonotril 0.5
Ye medicines bahut jyada hai sir...
Plz advice something

Dr. Sudhir Kumar said...

Exelon patch (rivastigmine) is used for treating dementia, and not Parkinson's disease.
Syndopa plus, amantadine and rasagiline are good drugs for Parkinson's disease.

Clonotril is used for treating anxiety.

SonaarTori said...

Dr. Kumar,

My father (aged c72 years) had been diagnosed with PSP about 2.5 years back.

The usual retinue of levodopa-carbidopa medications (Syndopa Plus-Ropark-Amantrel) had been prescribed, prescribed, but the effects seem to be tapering off. I have read that Dr. Paresh Doshi has successfully treated some PSP patients via Deep Brain Stimulation procedure.

Does this work or are the risks too high?

Dr. Sudhir Kumar said...

DBS is unlikely to be useful in PSP and I do not recommend this treatment in my patients.

Aniruddhsinh Parmar said...

Dear Sir, My father is diagnosed with the PD before 6 years and currently he is taking Ropark,Syndopa etc. but he is always says that it is not giving me any benefit if I am eating it or not in both the case my condition is same so I want to know that if we will stop the medication to avoid the side effects of it at later stage than what would be impact of it on my father's help.

anurag said...

My mother is suffering from PD from past 4 years ,in additon to that she has heart problem ,she is currently 70+,I am residing in noida currently ,could you suggest any good doctors here in near to delhi for her treatment.

Dr. Sudhir Kumar said...

Anurag, You can consult Dr Vinit Suri at Apollo Hospital, New Delhi.

Dr. Sudhir Kumar said...

Anirudh, If there is no benefit with medicines, your father can stop both syndopa and Ropark. These medicines are only for relief of symptoms and have no effect on disease progression.