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Take Sinemet And Mirapex For Right Sided Tremors. Diagnosed With Left Sided Brain Compression. Suggestion?

Posted on Thu, 10 Oct 2013

Question: DUKE TOLD ME I DO NOT HAVE PARKINSON'S DISEASE, BUT I DO TAKE SINEMET AND MIRAPEX FOR MY RIGHT SIDED TREMORS. AFTER HAVING A 3 TESALA MRI, I WAS DIAGNOSED WITH LEFT SIDED BRAIN COMPRESSION. DR. XXXXXXX jENNETTA FROM PITTSBURGH WAS WAITING FOR A XXXXXXX TO BE APPROVED FOR HIS TEST STUDY. HE IS NOW RETIRED AND I HAVE HAD THIS HORRIBLE RIGHT HAND AND RIGHT LEG TREMOR FOR 8 YEARS NOW. I AM 60 YEARS OLD AND I AM SEEKING A WELL QUALIFIED DOCTOR WHO CAN HELP ME. I AM SEEKING THE HELP OF A NEUROSURGEON. XXXXXXX XXXXXXX

Answered by Dr. Praveen K Nath (30 minutes later)

Brief Answer:
tremors right limbs

Detailed Answer:
respected ma,am
hello & my best wishes for a speedy & complete recovery
one sided tremors in a 60 year female without any history of trauma , mostly is due to parkinsonism . radiological investigations (MRI BRAIN etc ) may be normal in these patients .
my suggestions are

1. continue taking SINEMET & MIRAPEX. you may need an increase in dose & frequency to get the optimum result

2.you may try new antiparkinson medications under neurologist guidance

3 try some medications like PHENARGAN/ CHLORDIAZEPOXIDE etc along with your medications

4 consult a GAMMA KNIFE SURGEON for doing a radiosurgical treatment for you .
now a days gamma knife treatment is a new modality of treatment in parkinson,s patients who are not being adeqately controlled by medications

5 get regular physiotherapy & rehabilitation

thanx
dr XXXXXXX XXXXXXX XXXXXXX
director
deptt. of neurosurgery

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Praveen K Nath (9 hours later)

SIR: DO THEY DO GAMMA KNIFE TREATMENTS IN US AND WHERE? I DID FALL AND HIT MY LEFT SIDE OF HEAD WHILE IN THE MILITARY 43 YEARS AGO. MY MRI WAS NOT NORMAL. COULD THAT BE A CAUSE OF MY LEFT SIDED BRAIN COMPRESSION TO SHOW UP 35 YEARS LATER? IS MEDICAL MARIUANA A TREATMENT OPTION? WHERE DO YOU PRACTICE?

Answered by Dr. Praveen K Nath (16 hours later)

Brief Answer:
parkinson,s disease

Detailed Answer:
Respected ma,am
Hello
Get well soon
Gamma knife treatment is available in US at many centers. You can get list of centres in local directory/internet
One big gamma knife centre is available in PITTSBERGH .
If your MRI BRAIN is showing some gliosis/organic lesions, then gamma knife is not the answer. You need to maintain on medications & physiotherapy
Lot of 2nd & 3rd line treatment options are available
I practice neurosurgery in India. We have many gamma knife centres here also.

Thanks
Dr Praveen K Nath
Director
Deptt of neurosurgery

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen K Nath (22 hours later)

THEY SAY I HAVE MACCULAR DECOMPRESSION. WHATEVER THAT MEANS. IS MEDICAL MARIUANNA A TREATMENT OPTION? DO YOU STILL THINK I HAVE PARKINSON'S? THANK YOU SO VERY MUCH. MY DOCTORS DONT KNOW WHATS WRONG. XXXXXXX

Answered by Dr. Praveen K Nath (2 hours later)

Brief Answer:
Parkinsons / Dystonia

Detailed Answer:
Respected ma,am,

I feel what your doctor meant was that your brain is showing some degeneration of nerve tracts. If gliottic degeneration is noted on mri brain scans (may be due to old injuries), then gamma knife treatment is not the choice.

I have never heard of medical mariuanna treatment for this condition. Please discuss with your neurosurgeon.

I still feel that you have PARKINSONS / DYSTONIA. But the clinician who has examined you is the best judge.

Hope this helps.

thanx
dr XXXXXXX k XXXXXXX
director
deptt of neurosurgery

Above answer was peer-reviewed by : Dr. Prasad