������

Abstract

Since the time of James Parkinson, we have come to recognize a medical condition characterized by the gradual appearance of stiffness, slowness, reduced mobility, feeling old for oneâ�?�?s years, altered gait with stumbles, and even falls. Tremor is not always present. Families are often aware of these changes before the patient. At no stage in this condition is there an obvious illness. Parkinson, in his essay described just six cases. He recognized the slow progress of the condition over many years and that the clinical signs were asymmetric. Charcot and Gower found no neuropathological changes. Gower famously said â�?�?you do not die from Parkinsonâ�?�?s Disease (PD) but with itâ�?. We recognize â�?�?Non-Motorâ�? features of PD, the slow onset of PD over many years and the positive response of PD to L-Dopa Therapy. PD is now considered to be a disorder of the basal ganglia and with DAT scanning we can measure dopamine transporter uptake. Qualitative assessment of DAT scans reveals loss of the â�?�?Comma Shapeâ�? in PD cases but quantitative measurements reveal an obvious asymmetry in early PD cases. This data will be presented to show that PD (as opposed to Parkinsonism or PD plus syndromes) is a dopamine deficiency disorder and not a disease.

Biography

Rudy Capildeo is a Consultant Neurologist who set up one of the first PD clinics in London, UK in 1973 at The Charing Cross Hospital, where he also organized the first major International PD Symposium in 1979 when Sinemet Plus was first introduced by MSD. He was a Senior Investigator in the 5-year Sinemet CR First Trial. A frequent presenter in national and international meetings, he continues his interest in PD in his work and in his role as a Teacher.

Email: rcapildeo@uk-consultants.co.uk