Wednesday, January 19, 2011

Botox, Not Just For Wrinkles

Post 36
The most visible (and annoying) manifestation of my Parkinson’s is the constant twisting of my head. Dr. A and I have discussed it, but don’t quite know what it is. It seemed like Cervical Dystonia because my neck muscles repeatedly pull my head in one direction (i.e. to the right). This type of Dystonia is known as Rotational Collis. This Dystonia, however, is not Parkinson’s disease. My symptom seems to be exacerbated by the use of Carbidopa/Levodopa. If I take too much, the twist gets worse. It is also gets worse when I am tired or stressed.
The twisting is not bothersome when I am engaged in activities that keep me moving. I don’t know if it’s that I am not thinking about it, or if it actually goes away. Sometimes it disappears for a few hours for no reason.  When I sleep, my head doesn’t twist at all.
We first tried Clonazepam as a calming agent. Although it is useful during periods of stress, the drug doesn’t have much of an effect on the twist. We lowered my dose of Carbidopa/Levodopa and added Mirapex, a dopamine agonist, with some success. That is the regimen I follow today.
There is one more very good option available, one that I have carefully considered. It is Botox injected in the muscle that causes my neck to twist. Botox would paralyze the muscle. I would need an injection every three months.
It’s good to know that there are options. My quality of life expectations have not yet tipped the scales to accept the Botox cure. In time, I’ll probably give it a try.
Tomorrow: What is an Agonist?

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