Treatment stores

SPOTLIGHT ON MEDICINE: A game-changing tool alters the treatment journey for Parkinson’s disease

“The improvement has been drastic”

ROBERT SORGER FROM WEST MELBOURNE, right, arrived at the office of Health First neurologist Dr Carlos Berrios Rosado believing he had essential tremor. Now he knows it’s actually Parkinson’s disease and he’s on the right track. “Within a month, the tremors had practically disappeared. The improvement was drastic. (picture Health First)

Robert Sorger’s diagnosis of essential tremor was not entirely unexpected. His mother had it. His grandmother too. But until a Health First neurologist ordered a DaTscan test, he had no family history of Parkinson’s disease.

BREVARD COUNTY, FL – Robert Sorger of West Melbourne arrived at the office of Health First neurologist Dr. Carlos Berrios Rosado last year with a case of essential tremor that was literally spiraling out of control.

His right hand was bouncing violently in the air, and his former neurologist had prescribed him a veritable regimen of medication the size of a box of pencils, but still nothing worked. He was adamant about his diagnosis of essential tremor, “to the point of being belligerent about it”.

“My mom had it. His mom had it. It runs in the family, and it’s a natural thing to think about,” Robert says.

Essential tremor is often confused with Parkinson’s disease. They have similar symptoms – rocking and shaking, usually of the head, hands, arms and legs – but a very different etiology.

Dr. Berrios Rosado knew that when it came to Parkinson’s disease, a diagnosis that could be essential tremor should no longer suffice. He knew Robert could definitely rule out (or enter) Parkinson’s disease with something called a DaTscan test.

“Sometimes you can’t tell Parkinson’s disease from an essential tremor,” says Dr. Berrios-Rosado. “This test really changed the game.”

DaTscan is a contrast liquid that is introduced into the bloodstream. While circulating in the body, it goes to the brain, where it binds to a molecule present on the dopaminergic neurons.

A scan detects this, and in a healthy brain, dopamine neurons in a part of the brain called the striatum light up like long lobes, but patients with Parkinson’s disease have an unhealthy dopamine system that is shrunken and sluggish. fades.

HEALTH FIRST NEUROLOGIST DR. CARLOS BERRIOS ROSADO says there is no longer any reason to wonder whether a tremor is Parkinson’s disease or not. “We do the DaTscan. It comes back positive. We take [patients] stop all anticonvulsants and start taking dopaminergic medicine. They really have a better quality of life. (picture Health First)

The improvement was drastic

In Robert’s case, his test came back conclusive for Parkinson’s disease. His previous treatments – high doses of primidone – weren’t helping because they weren’t helping the dopamine network in his brain. With the correct diagnosis, he was able to begin therapy that changed his life.

“And lo and behold, in less than a month, the tremors were all but gone,” he says. “The improvement has been drastic.”
When essential tremors can be ruled out, treatment for Parkinson’s disease is targeted and impressive.

“If you have the correct diagnosis, it’s a totally different treatment. Okay, this person has a tremor, but his meds aren’t working. They don’t necessarily improve. They might have a little reduction, but it gets worse over time. We do the DaTscan. It comes back positive. We take them off all anticonvulsants and start them on dopamine meds. They really have a better quality of life.

Robert credits Dr. Berrios Rosado with “going the extra mile”. More than that, “he sensed my skepticism” and gave Robert an itinerary that not only broadened his understanding, but gave him immense hope.

After all, “Turns out my mom had Parkinson’s and she lived to be 94. If I get close to that, I’ll be happy.”

To learn more about Health First’s Neuroscience program, visit HF.org/neuro.