A Personal Story Dr Kenneth E Keirstead Excellence in Aging Care Symposium September 2527 2013 Why Me 72 year old Stage I diagnosed nine months ago Born in South Africa overdosing on DDT ID: 479341
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Innovations in Parkinson’s Diagnosis & Treatment: A Personal Story
Dr. Kenneth E. Keirstead
Excellence in Aging Care Symposium
September 25-27, 2013Slide2
Why Me?
72 year old Stage I diagnosed nine months ago
Born in South Africa overdosing on DDT!
No direct family history, but have outlived most of my forebears
Biggest first issue – denial
“Symptoms are mostly all in your head” “You’re not kidding!”Slide3
What is Parkinson’s Disease?A neurodegenerative disease with progressive loss of motor neuron cells
First described in 1817 as “Shaking Palsy”
“Idiopathic” condition or syndrome
Some indication of hereditary genetic factors (5-10%)
Recently about ten genes have been identified that link to PD
External chemical influence? Pesticides and insecticidesSlide4
Symptoms
Problems with walking and balance
Muscle aches and pain
Movement problems – difficulty starting movement such as walking or getting out of a chair
Slowed movement
Rigid or stiff muscles often beginning in legs
Anxiety, stress, depression and tremor
Truly idiopathic!Slide5
Diagnosis Medical history
Thorough neurological examination
No screening or lab tests to confirm diagnosis
MRI detection of
Lewy
Bodies
Response to replacement medicationSlide6
Progression of DiseaseSlide7
Progression of Disease (continued)Slide8
Insidious SymptomsSlide9
Frontal Lobe TheoryCommand Center Challenges
Affected processing
A possible precursor to more definitive diagnosis
“It’s all in the head”
Understanding brain plasticity
A new opportunitySlide10
Bring on the Dopamine!
Carbidopa
-levodopa – drug of choice
Other agents
Need for precise control (dosage, timing,
etc
)
Alleve
(naproxen sodium)
Self medication hypothesis
Rehabilitation and exerciseSlide11
Other TreatmentsResearch pipeline
Deep brain stimulation
Stem cells
Accurate assessments of disease state