As someone with Multiple Sclerosis (MS), I would not immediately associate my condition with Parkinson’s Disease (PD). But, both MS and PD are neurodegenerative diseases that are progressive in nature and have a number of common symptoms.
Very occasionally, PD and MS occur in the same patient. This occurrence has caused some researchers to investigate the possibility of a link between the conditions.
Neither PD nor MS have a cure. The condition do share a number of symptoms. However, these are distinct conditions with very different causes and diagnostic criteria.
KEYWORDS: limbs slurred speech, diagnose pd, neurodegenerative disorder, basal ganglia, substantia nigra, optic nerves
Early Detection is Key to Success
Early Treatment for Parkinson's Disease
There is some evidence that the signs of PD can be detected long before the motor control symptoms are evident.
While most treatment for PD involves prescribing medications to alleviate symptoms, exercise is is a simple treatment that can be implemented by the individual and is supported by medical professionals.
A symptom common to both MS and PD is restless legs.
Common symptoms of MS and Parkinson's disease
There are a number of symptoms of both MS and Parkinson’s Disease that have similarities.
- Fatigue
- Pain
- Urinary Problems
- Bowel Difficulties
- Sexual Issues
- Lightheadedness (Dizziness)
- Cognitive Dysfunction
- Anxiety and Depression
- Mobility Issues
- Sleeping Difficulty
- Muscle Spasms
- Speech Problems (Difficulty enunciating)
- Dysphagia (Swallowing Problems)
These symptoms may occur in either condition and may vary in frequency and severity.
Together, We Can Make a Difference
Slowing the Development of Multiple Sclerosis (MS)
Multiple Sclerosis (MS) is thought to be an autoimmune disease. It is a disease of the central nervous system characterized by lesions in the brain and spinal cord.
Because the optic nerve is an integral part of the central nervous system, vision problems are often the first sign of developing multiple sclerosis.
In order to make a diagnosis of multiple sclerosis, the attending neurologist will conduct an MRI scan to examine the brain for the presence of lesions. A lumbar puncture or spinal tap will be used to draw a sample of cerebrospinal fluid to test for telltale ptoyeins indicating myelin breakdown.
Myelin is the the fatty substance that forms a protective coating or sheath that surrounds and protects nerve fibers.
Probably because of a childhood infection the body’s immune system is tricked into seeing myelin as a foreign body.
The immune system response is to attack the myelin which causes inflammation to the protective sheath around the nerve fibers.
If the nerve fibers remain exposed, they will become permanently damaged causing the neurological symptoms seen in MS. This will result in the death of nerve cells.
Causes of MS
Genetic and environmental factors are suspected of having n influence on the likelihood of developing multiple sclerosis.
It is not thought that diet could be a potential cause, but diet can play a huge part in managing multiple sclerosis symptoms.
This feels like a good place to relate my own beliefs on the cause of my MS. When I say the cause of MS, I really mean the trigger for my MS.
Because the more I have tried to analyse my life and recall all the significant events that have occurred over the years, the more I suspect that I didn’t develop multiple sclerosis, I was born with multiple sclerosis.
My very earliest recollection of health issues was in a hospital, in France, as a small child. The memory that is thoroughly etched into my brain was me writhing and screaming as two nurses tried to restrain me so that I could be given an injection in my buttocks.
The MS Trigger
Apparently, I had contracted food poisoning and was seriously ill. Clearly, I recovered and retain the memory to this day. It is the first event that could have had a bearing on the later development of multiple sclerosis.
However, I digress, that was not the event that I suspect was the trigger for multiple sclerosis.
During the early 1990s, I found myself unemployed and scraping around for ways to make some money. At the time, my father was building a house and he needed a labourer. He agreed to pay me a small wage and he would provide accommodation in the shape of an old caravan.
I assisted my father for a few months until I became quite ill. I think I acquired a bad case of influenza. The work had been physically demanding, the weather had been typical Scottish weather; cold and damp.
I ended up in bed in this pokey little caravan for two or three weeks. Fortunately, by the time I recovered, most of the building work had been completed and I came home.
Within a matter of weeks, my first MS symptoms appeared. Obviously, at the time, I did not recognise the as MS symptoms because I knew very little about multiple sclerosis. Now, with the benefit of hindsight, this was the one thing that I could firmly pin MS on.
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Born with MS
Why do I think that I was born with MS? It’s the only thing that makes sense to me. As a child, I was very active but very sensitive to hot and cold weather. My mother was diagnosed with MS in her early thirties. A distant aunt of my mother had a serious neurological illness, that nobody can remember the name of.
My family had a history of neurological conditions. I, unknowingly, experienced many early signs of MS. I have had at least two serious illnesses, on top of the usual childhood infections of measles, mumps and chickenpox.
Diagnosing PD or Parkinson Disease
In many cases, doctors are looking for three telltale symptoms before making a diagnosis of Parkinson’s.
- Bradykinesia (slowness of movement)
- Tremors (uncontrollable muscle movement)
- Rigidity (Freezing of movement)
Postural instability is another sign of motor control limitation that can lead to balance issues and a propensity for falling.
Other movement symptoms include:
- Dystonia: which is a movement disorder that causes involuntary twitching, caused by muscle contractions.
- Dyskinesia: causes involuntary and erratic movement of the face, arms and legs. These spastic limb movements can be very disconcerting.
- Festination: Associated with the rigidity or freezing symptom, walking with short, rapid steps is a visible mnifestation of PD.
- Drooling: not usually considered to be a motor control issue, excess saliva may be the result of dysphagia.
While these are all possible Parkinson Disease symptoms, they can also be typical of other conditions.
Awareness is the First Step to Victory
Parkinson's vs MS
Is there a link? The chances of developing both conditions simultaneously are vanishingly slim. As few as 1 in 12.5 million are thought to be at risk.
However, at least 42 cases of people with both conditions have been reported. This relatively small number could be pure coincidence.
Some research suggests brain damage caused by MS increases the risk factors associated with developing Parkinson’s Disease.
Diagnosing MS
According to the National Multiple Sclerosis Society, in order to make a diagnosis of MS your doctor must:
- Identify two separate areas of CNS damage, in your brain, optic nerves or spinal cord.
- Find evidence that these areas of damage occurred at different times.
- Rule out all possible alternatives.
Your doctor will also take a blood sample to be analysed for other possible conditions.
There is no cure for multiple sclerosis but there are number of treatment that can slow disease progression.
Central Nervous System
In the early stages of multiple sclerosis, patients might be offered disease-modifying drugs to slow the disease progression. These drugs are only effective against MS when it is in the relapse-remitting stages. So a patient with CIS or RRMS may consider DMDs as a possible treatment plan.
Beyond this, exercise, diet and therapeutic exercise classes can help to manage MS symptoms.
If a change of diet can slow disease progression, which my experience suggests it can. We need to request a neurological examination to see if the dietary changes have made medical improvements to our condition.
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How therapy helps MS and Parkinson's
The independence and safety of patients of both PD and MS can be helped with physical therapy, occupational therapy and speech therapy.
Supportive therapies are a useful tool used to treat Parkinson’s and correct the poor posture brought about by numb or weak limbs.
My current therapy of choice is hyperbaric oxygen. I visit a treatment centre weekly, to spend an hour in the hyperbaric chamber.
In the hyperbaric chamber the air pressure is raised to 2 Atmospheres, or double the normal air pressure. The patients or participants wear an oxygen mask through which they breathe pure oxygen.
This increases the oxygen supply to the brain which promotes many healing functions of the body. In my case, it helps to reduce the cognitive deficits of Multiple Sclerosis. While the therapy lasts for only an hour, the benefits to the immune system can be felt for a week or two.
The cognitive deficits of multiple sclerosis are common symptoms. You may know them better as Brain Fog.
Parkinson's diagnosis
Early onset Parkinson’s disease can be very difficult to spot as the early signs could appear many years before the motor symptoms.
PD affects part of the brain called substantia nigra which can limit muscle control. Parkinson’s compromises the dopamine producing neurons of the basal ganglia.
Dopamine is an important neurotransmitter and Parkinson’s is caused by a loss of the cells that produce dopamine. The chemical called dopamine is responsible for many functions in the human body such as movement coordination.
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Treating MS
Because the cause of MS is uncertain, treating MS takes a symptomatic approach, targeting specific symptoms as and when they occur.
It is very important to start treatment a soon as possible after your diagnosis. In the first few months or even years after a diagnosis, the symptoms of multiple sclerosis may be very mild.
However, don’t be lulled into a false sense of security. Action should be taken now to minimise serious disability in the future.
This early intervention can delay disease progression of what is a neurodegenerative disease.
When the immune system attacks the nervous system, MS patients will begin to experience the slow progression of multiple sclerosis.
Treating Parkinson Disease
There isn’t a specific test to diagnose Parkinson’s Disease. Instead, the attending neurologist will based on the PD patients clinical symptoms and history, take a judgement on the condition of the Parkinson’s patients.
There are medications used to treat PD:
- levodopa
- dopamine agonists
- monoamine oxidase-B inhibitors
In advanced cases of Parkinson’s Disease, surgical intervention may be required. A procedure called deep brain stimulation can be used in the most severe cases.
Dopamine Agonists
A dopamine agonist (DA) is a medication that works by imitating the actions of dopamine when levels are low. By fooling the brain into thinking dopamine is available, DA’s improve condition-related symptoms.
However, because DA’s only imitate dopamine and don’t actually raise levels, long-term use can lead to intolerance and decreased effectiveness. Thus, it’s important that patients work with their doctors to find the right treatment plan.
MAO-B inhibitors
MAO-B inhibitors are a class of drugs that can be used to treat Parkinson’s disease in conjunction with other treatments. These drugs act by inhibiting the breakdown of monoamines in brain cells, which can help reduce some motor symptoms associated with PD.
By slightly increasing levels of dopamine and noradrenaline in the brain, MAO-B inhibitors may help alleviate symptoms such as stiffness, tremors, and difficulty initiating movement.
Studies have indicated that these medications have a modest but beneficial effect on relieving PD symptoms, depending on the severity and stage of the disorder.
Treatment and outlook
There is currently no cure for either multiple sclerosis or Parkindon’s Disease. However, treatments can limit or slow the progression of the diseases.
Outlook for MS
The nature of multiple sclerosis makes it impossible to predict the course of anybody’s journey with multiple sclerosis. I might have carried benign MS for my entire life had not adverse circumstances triggered the development of what is now SPMS.
The MS Trust published a list of factors that could produce a more favourable outlook:
- Receiving a diagnosis prior to the age of 40.
- You are a Woman.
- Only sensory symptoms, numbness and tingling, are experienced.
- Long intervals between periods of relapse.
- Having only a few relapses during the first few years after the diagnosis.
- Periods of remission with no apparent symptoms
Life expectancy with MS is likely to be a little shorter than that of the general public.
Outlook for Parkinson's Disease
People who have had a proper diagnosis of Parkinson’s disease should not be at higher risk of premature death.
Current medical treatments can slow the progression of Parkinson’s Disease and help with the physical functions of this and other movement disorders.
Parkinson’s disease and multiple sclerosis are very different diseases and although they share a number of symptoms, they are clinically distinct conditions.
Consequences of MS
When you first feel the body electric shock feeling of L’hermitte’s sign or the mild symptoms of muscle stiffness, you don’t immediately think of MS.
Even after you have been diagnosed with multiple sclerosis very few of the symptoms appear to be connected. But, the human body is such a complex biological machine, tiny failures in one region can have immense consequences elsewhere.
How have I survived nearly thirty years of living with MS? That is a very good question and, like so many questions around multiple sclerosis, may not have a satisfactory answer.
Ironically, I think my age may be in my favour. While MS is considered to be a disease of younger adults. The fact that I survived my younger years and made it to retirement age probably means that the disease is less active.
We know that multiple sclerosis is cyclic in nature, so maybe the disease is only resting and will return with vigour. What I believe is more likely is that with my advancing years my immune system has weakened and it is immune system activity that is at the root of MS.
So, a tired old immunity cannot be as destructive as a young virile protagonist.
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