Bob Cowart's Blog: Misdiagnosis of Parkinson's

Here's an amazing list of the possible causes of PD. I've been looking for a list this extensive for a long time. I saw one ages ago, and printed it out to take to my neuro doc but it was less complete than this. We never did follow up on all the possible clues and misdiagnoses. It's so easy to get a hunch and then take one potential chain of logic and then get mired in it. For me, that is typically Lyme and coinfections (TBDs), yet see how many other avenues there are to explore. (Thanks to my friends May and Hines for this article.) (copyright Right Diagnosis - www.rightdiagnosis.com)

-Bob

· Misdiagnosis

Contents

1. Parkinson's Disease: Introduction

2. Alternative Diagnoses List

3. Possible Misdiagnoses

4. Common Misdiagnoses

5. Rare Types

6. News about Misdiagnosis

7. Misdiagnosis Center

8. Parkinson's Disease: Introduction

9. Symptoms: Parkinson's Disease

10. Treatments

11. Tests

Misdiagnosis of Parkinson's Disease

A diagnosis of Parkinson's disease may be delayed or missed because it early symptoms are often vague, start slowly and generally progress gradually. Many people with early symptoms of Parkinson's disease assume their symptoms to be a normal part of aging. Symptoms of Parkinson's disease can also mimic symptoms of other diseases, disorders or conditions, such as depression, essential tremor, Huntington's disease and progressive supranuclear palsy....more about Parkinson's Disease »

Alternative diagnoses list for Parkinson's Disease:

For a diagnosis of Parkinson's Disease, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Parkinson's Disease:

· Essential tremor

· Progressive supranuclear palsy

· Secondary parkinsonism

· Parkinsonism-dementia complex of Guam

· Multiple-system atrophy

· Diffuse Lewy body disease

· Corticobasalganglionic degeneration

· Alzheimer's disease

· Lewy body dementia

· Post-hypoxic encephalopathy

· Whipple disease

· Neuroacanthocytosis

· Toxin-induced Parkinsonism

· Drug-induced Parkinsonism

· Arteriosclerotic Parkinsonism

· Postencephalitic Parkinsonism

· Manganese-induced Parkinson's disease

· Cardioembolic stroke

· Hallervorden-Spatz disease

· Lacunar syndromes

· Normal pressure hydrocephalus

· Parkinson-Plus syndromes

· Striatonigral degeneration

· Jakob-Creutzfeldt disease

· Prion diseases

· Shy-Drager syndrome

· Wilson's disease

· Huntington's disease

· Olivopontocerebellar atrophy

· Post-traumatic encephalopathy

· Vascular parkinsonism

· Depression

· Steele-Richardson-Olszewski syndrome

· Space-occupying brain lesions

· Rett syndrome

· Pick's disease

· Senile parkinsonism

· Hemiatrophy-hemiparkinsonism

· Binswanger's disease

· Postviral encephalitis

· Hypoparathyroidism

· Recurrent hepatic coma

· MPTP-induced parkinsonism

· Carbon disulfide-induced parkisonism

· Cyanide-induced parkinsonism

· Carbon monoxide-induced parkinsonism

Diseases for which Parkinson's Disease may be an alternative diagnosis

Related Parkinson's Disease Info

Related Pages

1. Parkinson's Disease: Introduction

2. Alternative Diagnoses List

3. Possible Misdiagnoses

4. Common Misdiagnoses

5. Rare Types

6. News about Misdiagnosis

7. Misdiagnosis Center

8. Parkinson's Disease: Introduction

9. Symptoms: Parkinson's Disease

10. Treatments

11. Tests

The other diseases for which Parkinson's Disease is listed as a possible alternative diagnosis in their lists include:

· Corticobasal Degeneration

· Dementia With Lewy Bodies

· Depression

· Diabetic Gastroparesis

· Fahr's Syndrome

· Huntington's Disease

· Interstitial cystitis

· Lyme disease

· Muscle cramps

· Myoclonus

· Neurogenic bladder

· Normal Pressure Hydrocephalus

· Prion disease

· Progressive Supranuclear Palsy

· Shy-Drager Syndrome

· Wilson's Disease

Parkinson's Disease: Hidden Causes Misdiagnosed?

Causes of Parkinson's Disease may include these medical conditions:

· Encephalitis

· Brain tumor

· Head injury

· Brain injury

· more causes...»

Rare Types of Parkinson's Disease:

· Herbicides and pesticides associated parkinson's disease

· Idiopathic Parkinson's disease

· Autosomal dominant Parkinson disease

· Parkinson disease, familial, type 1 (PARK1)

· Parkinson disease 3, autosomal dominant Lewy body (PARK3)

· Parkinson disease 4, autosomal dominant Lewy body (PARK4)

· Parkinson disease 5 (PARK5)

· Parkinson disease 6, autosomal recessive early-onset (PARK6)

· Parkinson disease 2, autosomal recessive juvenile (PARK2)

· Parkinson disease 7, autosomal recessive early-onset (PARK7)

· Parkinson disease 8 (PARK8)

· Parkinson disease 9 (PARK9)

· Parkinson disease 10 (PARK10)

· Parkinson disease 11 (PARK11)

· Parkinson disease 12 (PARK12)

· Parkinson disease 13 (PARK13)

· Mitochondrial Parkinson's disease

· More rare types »

Parkinson's Disease: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

· Brain & Neurological Disorders: Undiagnosed:

o Adult ADHD -- Undiagnosed - ADHD can be undiagnosed in adults.

o ADHD -- Undiagnosed

o Alzheimer Disease -- Undiagnosed

o Migraine -- Undiagnosed

o Concentration Disorders -- Undiagnosed

o Stroke -- Undiagnosed

o Bipolar Disorder -- Undiagnosed

o Schizophrenia -- Undiagnosed

o Epilepsy -- Undiagnosed

· more undiagnosed conditions...»

Common Misdiagnoses and Parkinson's Disease

Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer's, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30's and 40's. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

Tremor need not be Parkinson's disease: There is the tendency to believe that any tremor symptom, or shakiness, means Parkinson's disease. The reality is that there are various possibilities, such as benign essential tremor, which is mostly harmless. see the various causes of tremor and misdiagnosis of Parkinson's disease.

Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury. See the symptoms of MTBI or misdiagnosis of MTBI.

MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury. See causes of dizziness, causes of vertigo, or misdiagnosis of MTBI.

Rare diseases misdiagnosed as Parkinson's disease: A rare genetic disorder is often misdiagnosed as Parkinson's disease for men in their 50's. The disease Fragile X disorder can show only mild symptoms in the early years, and Parkinsons-like symptoms around age 50. See misdiagnosis of Parkinson's disease.

Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH. See misdiagnosis of Alzheimer's disease or misdiagnosis of Parkinson's disease.

Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury. Seeintroduction to concussion.

Children with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in children. See misdiagnosis of migraine or introduction to migraine.

Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis). See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.

Parkinson's Disease: Rare Types

Rare types of medical disorders and diseases in related medical areas:

· Brain & Neurological Disorders: Rare Types:

o Adult ADHD -- Rare Types

o ADHD -- Rare Types

o Alzheimer Disease -- Rare Types

o Migraine -- Rare Types

o Concentration Disorders -- Rare Types

o Stroke -- Rare Types

o Bipolar Disorder -- Rare Types

o Schizophrenia -- Rare Types

o Epilepsy -- Rare Types

o Parkinson's Disease -- Rare Types

o more ...»

· Chronic Major Diseases -- Rare Types:

o High Cholesterol -- Rare Types

o Heart Disease -- Rare Types

o Cancer -- Rare Types

o Depression -- Rare Types

o Type 2 Diabetes -- Rare Types

o Type 1 Diabetes -- Rare Types

o Hypertension -- Rare Types

o Hemochromatosis -- Rare Types

o Metabolic Syndrome -- Rare Types

o Thyroid Disease -- Rare Types

· Senior Health: rare types of diseases:

o Diabetes -- Rare Types

o COPD -- Rare Types

o Emphysema -- Rare Types

o Heart Failure -- Rare Types

o Prostate Cancer -- Rare Types

o Breast Cancer -- Rare Types

· more rare diseases...»

Failure To Diagnose Parkinson's Disease

Failure to diagnose Parkinson's Disease may be associated with the following:

· The variability of symptom severity, type and rate of progression amongst patients makes diagnosis difficult - especially in the early stages.

· Parkinson's disease often remains undiagnosed for periods of times because the early symptoms are put down to the normal results of aging

· Parkinson's can be difficult to diagnose as there are many different types depending on the genetic mutation involved

· Some early-onset forms of Parkinson's disease are not diagnosed or misdiagnosed because Parkinson's disease is primarily considered a disease that occurs in older people. Some forms of Parkinson's starts as early as childhood

· The early symptoms of Parkinson's are often fairly subtle (tiredness, malaise, shakiness, movement difficulty) and so the condition often remains undiagnosed until more obvious symptoms such as tremor develops

· Although the primary symptoms associated with Parkinson's disease, the early symptoms may be only anxiety and sleeping problems which makes the condition less likely to be diagnosed in the early stages

· Some studies indicate that there are probably as many people wrongly diagnosed with Parkinson's disease as there are people with the disease and not yet diagnosed

Notes On Hidden Causes Of Parkinson's Disease

The following may be hidden causes of Parkinson's Disease:

· There are a number of theories as to the cause of Parkinson's disease: genetic predisposition, inheritance, toxin and drug triggers, accelerated aging and free radical damage. Many believe it is a combination of genetic and environmental factors

· Environmental risk factors for the development of Parkinson's disease includes: drinking well-water, exposure to pesticides and herbicides, living close to industrial factories and quarries or living in a rural environment

· Trauma and illness may also trigger or exacerbate Parkinson's disease

· There are a number of conditions that have various triggers and produce symptoms similar to Parkinson's disease and are therefore referred to as Parkinsonism. These disorders are often confused with Parkinson's disease which can lead to inappropriate treatment. Examples of Parkinsonism disorders are:

· Postencephalic Parkinsonism may be caused by viral diseases such as encephalitis lethargica and less often, by eastern equine encephalomyelitis, Japanese B encephalitis and western equine encephalomyelitis. This is a very rare cause of parkinsonism but patients should still advise their health professional if they have had any recent viral illness

· Manganese produced in welding rod fumes can cause Parkinsonian symptoms. The symptoms tend to start relatively early (5th decade of life) and often persist for the rest of their life

· Drug-induced Parkinsonism is reversible and may be caused by drugs such as haloperidol, chlorpromazine, metoclopramide and reserpine. Thus it is important for patients to inform their health professional of all their medications (or any exposures to toxins) as it may prevent of misdiagnosis of Parkinson's disease when in fact the symptoms were caused by the drugs and are reversible. Symptoms in drug-induced parkinsonism tend to start suddenly and usually involve changes in the mental status

· Arteriosclerotic Parkinsonism is caused by damage to the brain that results from small strokes due to blood vessel disease

· Toxin-induced parkinsonism may be caused by toxins such as carbon disulfide, carbon monoxide and manganese dust

Notes On Wrong Diagnosis Of Parkinson's Disease

Wrong diagnosis of Parkinson's Disease may be associated with the following:

· Parkinson's may be misdiagnosed as other neurodegenerative disorders such as Niemann-Pick disease as it can also involve tremors which are characteristic of Parkinson's disease

· The lack of testing that can conclusively diagnose Parkinson's disease makes the condition difficult to diagnose. Often testing is done to exclude other possible causes of the symptoms

· Movement disorders caused by other conditions may be misdiagnosed as Parkinson's disease

· Some forms of parkinsonism may be associated with other conditions which can lead to a misdiagnosis: Shy-Drager syndrome, progressive supranuclear palsy, Wilson's disease, Huntington's disease, Hallervorden-Spatz syndrome, Alzheimer's disease, Creutzfeldt-Jakob disease, olivopontocerebellar atrophy and post-traumatic encephalopathy. Parkinsonism refers to symptoms similar to Parkinson's disease but caused by other conditions

· Parkinson's disease may be misdiagnosed as dystonia, essential tremor or other movement disorders. Essential tremor is particularly prone to misdiagnosis due to it's similarity to Parkinson's symptoms (i.e. they both involve tremors as a symptom). Some patients have Parkinson's as well as essential tremor which can make diagnosis particularly difficult

· Idiopathic Parkinson's disease may be misdiagnosed as multiple-system atrophy

· Diagnosis may be difficult when other neurodegenerative disorder co-exist such as Alzheimer's

· Dementia can occur in the later stages of Parkinson's disease in up to a quarter of patients. This makes the condition almost indistinguishable from Alzheimer's and hence a wrong diagnosis can result

· Researchers believe that a significant number of patients are initially misdiagnosed with Parkinson's disease. A patient delivered with a diagnosis of Parkinson's disease should always be monitored over a period of time as changes in the symptoms may eventually point to an alternative diagnosis

· Studies indicate that misdiagnosis of Parkinson's disease by general practitioners often stems from the fact that they don't have sufficient knowledge about the disease. Frequently the GP will treat them without referring them to a specialist but the disease is complicated and an accurate diagnosis is vital to allow appropriate treatment

· Elderly patients who develop Parkinson-like symptoms as a result of taking medications to treat nervous disorders and dementia are often misdiagnosed as having Parkinson's disease rather than drug-induced parkinsonism

· Dementia with Lewy bodies also produces similar symptoms to Parkinson's disease and misdiagnosis is likely

Complications Of Misdiagnosis Of Parkinson's Disease

The following may be complications of misdiagnosis of Parkinson's Disease:

· Depression is sometimes the first symptom of Parkinson's disease and it may be misdiagnosed simply as isolated depression

· The sad facial expression and psychomotor retardation associated with depression may be misdiagnosed as Parkinson's disease. Diagnosis can be increasingly difficult if both conditions are present

Other Notes On Misdiagnosis Of Parkinson's Disease

· Patients whose predominant symptom is tremors tend to have a better prognosis and usually respond better to Levodopa treatment. Patients with walking problems and postural instability tend to have a poorer prognosis and response to treatment is usually also poorer

· Due to the difficulty in diagnosing Parkinson's disease, patients should ask for a second opinion if they feel unsure about the diagnosis they were delivered. An accurate prompt diagnosis allows appropriate treatment which enables the patients to manage their symptoms better and hence enjoy a better quality of life for longer

· Often a misdiagnosis of Parkinson's is only discovered on autopsy

· Certain symptoms that may indicate Parkinsonism rather than Parkinson's disease are: lack of tremor, gaze abnormalities and early hallucinations, dementia and falling

· Levodopa used to treat Parkinson's disease can have serious side effects so a person misdiagnosed with the condition is suffering the negative effects of the treatment without any benefit. Drug therapy should always be monitored by a Parkinson's disease specialist

· Parkinson's disease patients face a greater risk for osteoporosis and should thus be monitored accordingly

· Some doctors advise a course of Levodopa and apomorphine and if the patients symptoms improve, then the diagnosis is more likely to be Parkinson's disease

Medical news summaries about misdiagnosis of Parkinson's Disease:

The following medical news items are relevant to misdiagnosis of Parkinson's Disease:

· Development of possible diagnostic test for essential tremor is in sight following discovery

· Dystonia symptoms are often undetected or misdiagnosed

· Essential tremor information

· Lyme disease frequently misdiagnosed

· New disorder discovered that causes adult tremors

· Normal pressure hydrocephalus frequently misdiagnosed in the elderly

· Parkinson's disease can be diagnosed by testing sense of smell

· Wilson's disease is a rare and frequently misdiagnosed condition

· Young woman suffers multiple misdiagnoses before early onset Parkingson's diagnosed

· More news »

Misdiagnosis and Parkinson's Disease deaths

Parkinson's Disease is a condition that can possibly be deadly if misdiagnosed...more »

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

· Misdiagnosis Overview

· How Common is Misdiagnosis?

· Over-Diagnosed Diseases

· Under-Diagnosed Diseases

· Types of Misdiagnosis

· Wrong Type Misdiagnosis

· Why Does Misdiagnosis Occur?

· Difficult Diseases to Diagnose

· More premium medical articles ...

About misdiagnosis:

When checking for a misdiagnosis of Parkinson's Disease or confirming a diagnosis of Parkinson's Disease, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Parkinson's Disease may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Parkinson's Disease. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.

» Next page: Undiagnosed Parkinson's Disease

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