Should’ve been a gunslinger

https://core.ac.uk/download/pdf/94982300.pdf

"Gunslinger’s gait": a new cause of unilaterally unilaterally reduced arm swing. BMJ Online 351:h6141 · Dec. 2015 R.Araujo, J.J.Ferreira, A.Antonini, B.Bloem

“…an asymmetrically reduced arm swing …can be the earliest presenting sign of Parkinson’s disease…

We propose that this new gait pattern, which we term "gunslinger’s gait," may result from a behavioural adaptation, possibly triggered by KGB or other forms of weapons training where trainees are taught to keep their right hand close to the chest while walking, allowing them to quickly draw a gun when faced with a foe. This should be included in the differential diagnosis of a unilaterally reduced arm swing.”

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In October 2002 I had been told that I had a ‘tic’. The report from this first appointment with a movement disorder specialist noted Dystonia, Myoclonus and Chorea.

In December 2002 I was given a drug called Sulpiride.

By mid-September 2003 the physiotherapist noted the following : s tiff right elbow , ache in right shoulder blade,

bilateral shoulder pain, chest pain, difficulty walking, tension in shoulder, food gets stuck at back of tongue , can go down wrong way, choking, stiffness in arms/neck worse when walking, neck pain, tightness right side of neck

neck flexed, right arm flexed at elbow, bilateral shoulder girdles elevated, no armswing right.

By January 2004 the speech therapist had also noted drooling and another physio noted reduced trunk rotation.

No-one told me anything about tardive dyskinesia or parkinsonism

Sulpiride in tardive dyskinesia . Casey DE, Gerlach J, Simmelsgaard H. Psychopharmacology (Berl). 1979;66(1):73-7.

Tardive dyskinesia can be suppressed by drugs that block dopaminergic receptors, but often at the cost of a concomitant increase in parkinsonism.

Tiapride in levodopa-induced involuntary movements A.J. LEES, C. M. LANDER, AND G.M.STERN Journal of Neurology, Neurosurgery,and Psychiatry, 1979, 42, 380-383

The therapeutic possibilities of selective dopamine receptor blockade led to the use of haloperidol (Klawans and Weiner,1974) and pimozide (Tarsy et al., 1975) in the treatment of levodopa-induced peak dose dyskinesias.

Both drugs effectively suppressed involuntary movements but caused an unacceptable increase in disability

from Parkinsonism.

A double blind trial of sulpiride in Huntington’s disease and tardive dyskinesia N Quinn and CD Marsden Journal of Neurology, Neurosurgery, and Psychiatry, 1984, Vol 47, 844-847

The low incidence of drug-induced parkinsonism in Huntington’s disease patients may simply be a reflection of the difficulty of recognizing it in the presence of marked chorea

By contrast, signs of emerging or worsening parkinsonism were seen in seven of the nine tardive dyskinesia patients.

In five of them it was evident after only two weeks treatment with sulpiride

The dystonias .C.D.Marsden and N.P.Quinn. BMJ 1990 Jan 20; 300(6718): 139–144.

Dopamine receptor agonists or neuroleptics or such as phenothiazines, haloperidol, or pimozide are also sometimes useful. Often they act non-specifically, damping down excessive movements by causing a degree of drug-induced parkinsonism; there is also the risk of adding a tardive dyskinesia to the dystonia.

Parkinson’s Disease and other Movement Disorders M.J Edwards, M. Stamelou, N.Quinn, K.P Bhatia OUP 2016

p.129 Sulpiride Main side effects: extrapyramidal side effects (parkinsonism, acute dystonic reactions, tardive dyskinesia, akathisia) …Neuroleptic malignant syndrome is a rare, but important side effect

Appletree
Probably where I am from. Students studying to be movement specialists must be taking medicine for anxiety. (gunslinger syndrome) Good thing the only guns I own were 12Ga shoot guns for bird hunting with the dogs. (hunting done now) That way I got the proper assessment while walking. And the CIA had no reason to keep an eye on me.
The article made me remember once before diagnosis my wife and I went to a party. Wife RN intensive care at that time. Without me realizing it a student that was at the party, excepted in a movement specialist program observed my walk and posture.

In a short time the student introduced himself to my wife and I. He continued a conversation asking me how long I had parkinson’s? Not ever hearing that and only being told my physical problems were from sports injuries.(general family doctor)

I wish at that time I could of told him he was incorrect. That it was just that I was Former KGB. Well now I have really messed up! Our government has words that if you say them on your computer you are put on a watch list. LOL

Now I have messed up again. I bet the UK has the same program! Apple tree you are now on their watch list. (sorry)

Keep fighting Parkinson’s and thanks for posting the study. Tom

That’s how our Billy Connolly found out about parkinson’s - someone just came up to him

And talking of humour – the secret weapon in the parkinsonian armamentarium. This is what I grew up with:

Monty Python the fish slapping dance

Appletree
We used to get Benny Hill here in the states. Loved his show. Some of his skits would of not been liked by the Pope.
But I laughed at them on Late Saturday evenings. And on Sunday I visited the confessional. I think the priest may have been upset when I was on vacation. Because he would miss that weeks show! Tom