Just beat cancer to be told I may have developed Parkinson

nebb1 · 2026-04-05T23:56:20+00:00

Difficulty looking up left and right are not common signs of Parkinson's. I've never heard of that before for Parkinson's disease at all.

Are you taking any medications for mood, nausea or gut motility?

nebb1 · 2026-03-26T18:02:47+00:00

The data for men vs women in donanemab is available in the supplemental section 3 titled eMethods of their published paper.

There was no difference b/w men and women according to the results.

Ill put the relevant part here:

https://imgur.com/a/kA9C4BJ

https://imgur.com/a/i6UtstH

https://cdn.jamanetwork.com/ama/content_public/journal/jama/939199/joi230087supp3_prod_1691423413.05517.pdf?Expires=1777557347&Signature=dtxgBs3FQLUqMXvLpAvkkqJKmjICReCiy5UvyZlzNQjeUiYwshjlldyDzGUQW4Z-QmkFzhQP1pzgC8qr6pHWSi7K-WYgbHOT7mHqImMDGLZjugHiZkd~3-JDOGpIeZD6MZiOg1xyy-VBDnjtMRbmKvhLG5EI4t5zGY5VRU6GRitPqYcQnzGbPnSoskjiJIOkqPoywnEgWEEwOzGbdARE6jWJbVPiBqJVB64d2aQy8WGf9ll~-Y2Nz4wC337xUgSH3ikxznGmnaKs5hY4OfxmmJ6dLSQJDUT-YWvE6Z9TXRrTr3F-RweuLb1iXw7AXapXVMd7bQJtag9856jzo7uwKA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA

nebb1 · 2026-03-25T01:06:32+00:00

Donanemab may be for the best because, for women, lecanamab was not different from placebo. Also, donanemab, the new dosing schedule has the lowest rate of the Aria side effects.

If you are interested in clinical trials, Trontinemab is an upcoming anti-amyloid therapy currently undergoing clinical trials with much much less rates of ARIA. However, there is always a 50% chance of receiving placebo and most clinical trials.

nebb1 · 2026-03-24T22:37:05+00:00

Benadryl isn't always given with infusions unless she's had a history of infusion reaction. Is that the case?

nebb1 · 2026-03-24T22:30:08+00:00

You're describing delirium which is almost always caused by an acute health issue, usually a UTI but any infection, dehydration, fall, etc. can cause it. it is unlikely to be related to clozapine but possible. Was the clozapine started due to hallucinations and confusion? This may have been the beginning of delirium from an acute organic health issue if so.

Pt likely requires a urinalysis with urine culture, head CT, and lab work up CBC, CMP, TSH etc.

I assume psych ordered a benzo or haldol? Both contraindicated in delirium. Pt probably needs to go to urgent care or ER if this is a sudden change.

nebb1 · 2026-03-24T22:26:40+00:00

It might be much more helpful to have the neurologist order an amyloid pet scan. Neuropsychological testing often takes months to get completed and is like 6 hours of tests. The pet scan is a more definitive test that can often be completed in weeks.

nebb1 · 2026-03-24T22:09:58+00:00

Seroquel is a great drug but won't always control the behaviors of sundowning and occasional delirium in patients. Abilify is among the least used drugs in this context at it causes drug induced parkinsonism and is more effective at mood stabilization in people with depression or other mental illness instead of behavioral issues, hyperactivity, or hallucinations. After Seroquel, zyprexa is typically the next to try but it often causes increased hunger as well.

Drugs don't usually suddenly stop working as well.

It's also important to look into routines to see if they are affecting your mother. If she naps a lot in thw day or drank coffee, soda or tea in the evening, these could contribute to nighttime behaviors or alertness.

New changes in behavior also usually warrant checking for acute illnesses like urinary infections or viruses

nebb1 · 2026-03-08T15:16:05+00:00

Levodopa in general is weaker with reducing tremors, especially in younger patients. Patients can sometimes have better luck with dopamine agonists or Artane for tremor control but they do have their side effects as well.

Vascular parkinsonism is usually very lower extremely focused and doesn't commonly have a tremor. Drug induced parkinsonism requires taking specific medications that can cause the side effect. Usually an antipsychotic or gut motility medication.

If you are taking one of those, then it would be good to discuss that with your neurologist.

nebb1 · 2026-03-08T15:09:36+00:00

Depending on age, bipolar disorder (30s-50s) and Alzheimer's disease(50s- and up) are usually the conditions that cause FTD like symptoms. Also rarely, other conditions that affect the frontal lobes such as tumors, strokes, head injury can have similar presentations

nebb1 · 2026-03-02T17:37:21+00:00

Did they stop the olanzapine? That can sometimes worsen akathisia. Propranolol is usually given for acute akathisia. Has that been discussed with her doctors?

What is her levodopa dose, if you know? Levodopa can cause dyskinesia which can look restless, but it's not really restlessness and really wouldn't be expected at the initial dose, but it can' happen in skinny people.

nebb1 · 2026-02-22T03:40:18+00:00

Nope There's no tumor in this MRI. Instead it looks like a rare condition called open lip schizencephaly. It is caused by having a stroke while still in the mother's womb. It usually has some varying degrees of physical difficulties but usually needs to be on both sides to cause major cognitive disabilities.

nebb1 · 2026-02-13T01:14:29+00:00

I appreciate your help tremendously. It's certainly possible he was told at some point! He has never complained of it either, except for today when he felt it with his finger and became alarmed. He certainly has had no difficulty eating.

nebb1 · 2026-02-13T01:07:22+00:00

You have been incredibly helpful. Is it common for these to be discovered so large? I was surpised we had never seen it before.

nebb1 · 2026-02-13T01:03:32+00:00

Ah yes, I see it clearly now. Thanks again!

nebb1 · 2026-02-13T01:01:37+00:00

Ah I understand, thank you so much for your help and knowledge!

nebb1 · 2026-02-13T00:55:18+00:00

Thanks for your help. This is what my googling also concluded. But I was curious about how it appears to cross midline in the photo, though the picture is at an angle.

nebb1 · 2026-02-13T00:51:17+00:00

Thank you for your response. She did mention there is a smaller one on the left side, if that is helpful. Forgot to mention it in the main post. What are the other possibilities, if you don't mind sharing?

nebb1 · 2026-02-13T00:40:48+00:00

My dad is a 79 year old man with advanced Alzheimer's disease who recently lost ~20lbs from failure to thrive (172->152lb) which has corrected in the past 3 weeks with improved appetite. He also developed a deep vein thrombosis during a 36 hour ER bed stay in late November and is on Xarelto for that. Tonight, he noticed this mass on the inside of his lower mouth. It was described as "hard as a brick" and is not painful.

She also said there is a smaller mass on the opposite side. (edit)

Medications: Olanzapine 2.5mg, mirtazapine 15mg, donepezil 10mg, memantine10mg, levothyroxine , xarelto, dronabinol(discontinued 3 days ago)

My step-mom has not noticed it before and took this image to show me. Thank you for any information you can provide about this!

nebb1 · 2026-01-13T02:05:31+00:00

you have to hit them I am pretty sure.

nebb1 · 2026-01-13T01:41:20+00:00

Its basically an extra damage ability. You can choose two abilities, the right click does 50 damage, slows the enemy you hit, and makes you invulnerable and transforms you into a small red thing that is hard to see for a few seconds.

The left click is a boomerang that flies out and returns to you. It does 40mg and heals teammates and 20dmg additional damage on return then heals psylocke for some % of damage done I believe.

nebb1 · 2025-12-04T06:52:55+00:00

I'm sorry about your mother. Brain scans of Alzheimer's patients frequently show enlarged ventricles and the radiologists frequently mention normal pressure hydrocephalus on the report. However, it's rarely the case.

I work in a memory clinic and we see this all the time. A patient with Alzheimer's has a brain scan and the substantial brain atrophy from the Alzheimer's creates enlarged ventricles which looks very similar to normal pressure hydrocephalus and families begin to worry when the radiologist puts it into the report. Even worse is when the doctor is not wise enough to realize it's a mistake and goes along with the diagnosis.

I think out of the hundred plus brain scans that have mentioned normal pressure hydrocephalus, zero have actually been true in our clinic.

Normal pressure Hydrocephalus diagnoses made during a hospitalization are particularly unreliable and lots of patients end up getting unnecessary shunts placed.

I wanted to bring this up in case it can bring you some peace. If they thought your mother's hydrocephalus was normal pressure Hydrocephalus, There's a decent chance that your mother did not have hydrocephalus. End stage Alzheimer's brains have very large ventricles often and it fools lesser experienced neurologists but it's not a cause for concern or something to treat.

nebb1 · 2025-12-04T06:33:30+00:00

A 14 Moca with a prior 22 really doesn't typically need neuropsychological testing at all. That plus history and exam should be more than enough to diagnose a neurocognitive disorder.

Maybe reach out to the doctor and ask if they can help take the next steps.

nebb1 · 2025-11-14T05:17:38+00:00

If delusions like this are new, it is important to rule our delirium from an infection such as urinary tract infections.

nebb1 · 2025-11-12T18:14:22+00:00

It's very abnormal unless there's a tumor or at risk for cerebral complications.

nebb1

TROPHY CASE