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dominic
29-04-2005, 03:26 PM
I'm pretty freaked out at the moment. A good friend of mine -- from the UK, no passport, no papers, no real money, no insurance -- is in the hospital right now b/c his legs went completely numb on him yesterday morning. He has since recovered some movement but still has great difficulty maintaining his balance and basically cannot walk. No physical trauma seems to have caused this episode, at least not directly and immediately.

For as long as I've known him, however, which has been for roughly two years, he has had this very weird gait. I'm now wondering if this is the so-called "shuffling gait" that people with Parkinson's disease have. He's also had a couple episodes, all within past 8 months, of losing his balance completely and falling forward or backward. And he has chronic back and leg pain.

I had attributed his ailments to injuries that he may have sustained while working as furniture mover a few years back. He said that he once had his foot run over by a moving van (not sure if I believe that one!). He also told me that he had a couple bullets go through his legs when he was young

But frankly, I never gave his physical problems much thought. So he had a strange gait, and I thought "whatever." Part of his charm.

Now I'm sitting here wondering why he's in the hospital right now. And I can't help but think Parkinson's. And I'm starting to flash on Richard Pryor. My friend is not a cocaine addict in the sense that some other people I know are, wherein they go on massive 72-to-96-hour binges and then suddenly crash and sleep very fitfully for like 48-to-72 hours and constantly twitch. But that said, he probably does cocaine 6 or 7 nights a week, not loads of cocaine (b/c his only jobs are djing jobs at small bars, and he more or less relies on the good will of people like me, i.e., he's a serial sofa surfer, and hits my place about once a week), but pretty much every night. A couple beers, a couple drinks, a few lines. And he has a fair share of benders, I suppose, but benders are all relative (i.e., my bender is not your bender). And he's been living like this for past 20 years. He's 35. And I'm sure back in the 90s he knew plenty of pop stars and rock stars to give him free drugs, or at least he claims he got tons of free drugs . . . . That is, he's very charming, has no problem making friends, definite 24-hour party person type figure, so he's certainly done lots of drugs despite probably never really being able to afford such drugs . . . . Says that he used to deal lots of coke, but again, I'm not sure if such claim is true or merely part of his self-mythology . . . . That is, I don't necessarily believe anything that he says about his past . . . . So when he talks about the excesses of his past, I tend to discount such talk as boasting and self-mythology

But now I'm wondering if he indeed has done such quantities of cocaine over the years that he could have the same syndrome as afflicted Richard Pryor

Is anybody here knowledgeable about the neurological effects of long-term cocaine use, especially as relates to Parkinson's disease or some such other syndrome?

Ecstasy is of course the other drug he's done lots of -- but many years ago in terms of big-time use

He himself thinks that cocaine is culprit -- and even told me last night that snorting cocaine has recently caused him to have balance problems and numbness problems almost immediately after snorting

and he was doing cocaine the other night, of course, when he's legs went completely numb

again, he's since recovered some movement and control of the legs, i.e., he was able to get on to a scale to be weighed at hospital last night

and doctors have yet to determine what's wrong with him, let alone say why he has the condition or what his prognosis is

i am of course speculating when i say Parkinson's caused by chronic cocaine use

but again, is anyone here knowledgeable about this kind of thing?

bassnation
29-04-2005, 10:39 PM
I'm pretty freaked out at the moment. A good friend of mine -- from the UK, no passport, no papers, no real money, no insurance -- is in the hospital right now b/c his legs went completely numb on him yesterday morning. He has since recovered some movement but still has great difficulty maintaining his balance and basically cannot walk. No physical trauma seems to have caused this episode, at least not directly and immediately.

no-one really knows what causes parkinsons. but doctors believe its a combination of genetic and environmental factors. whether that might include cocaine is anyones guess. parkinsons occurs when more than 80% of the brain cells responsible for producing dopamine are damaged.

cocaine blocks dopamine re-uptake in the neurons of the brain, leading to enormously large quantities of dopamine being present. its this concentration that produces the euphoric effect - although doctors believe there is also other factors at work beyond dopamine because people remain high even after levels have subsided.

theres evidence to suggest that cocaine damages or even destroys some dopamine receptors but a link to parkinsons has not really emerged.

my grandad had parkinsons, he got it when he was in his mid thirties. spent all his life corresponding with other sufferers round the world but the disease is still as much a mystery now as it was then.

the other possibility is pyschosomatic disorders. i've known people lose feeling in their legs after big amphetamine binges when maybe they are freaking out a bit, ringing for an ambulance only to be given valium at the hospital and sent home again. of course, i'm not suggesting your mate is making it up, or its not real. but cocaine is a powerful pyschoactive drug which is easily capable of seriously fucking with anyones mind.

dominic
30-04-2005, 10:56 AM
i've been doing some internet research, not that i know anything about medicine

seems that Richard Pryor had MS, and there's no established link b/w cocaine abuse and MS

there is an established link b/w cocaine use and parkinson's, but i don't think my friend has symptoms of parkinson's -- i.e., he has a very weird way of walking but takes long & vigorous stride (and according to his mother has always walked that way, as i mentioned his weird gait to her) -- w/ parkinson's shuffle the steps are short & feeble & uncertain -- plus he has no tremors in his hands -- no shaking

i'm beginning to suspect (hope) he has cocaine-induced periodic paralysis involving abnormalities of potassium channel

such abnormalities may be congenital or episodically caused by cocaine use -- i.e., cocaine reversibly blocks the channels for HERG-potassium currents

the other possible mechanism is that the adrenergic effects of cocaine lead to an intracellular shift in potassium levels causing hypokalaemia = potassium deficiency in blood (which can be treated with potassium supplements)

there are several reported cases of cocaine-induced hypokalaemic periodic paralysis = patients have acute onset of paralysis but then recover within 72 hours

(except my friend's earlier episodes were never anywhere near as severe as this one -- i.e., he merely had a couple falls, or had difficulty moving, but never anything like this -- and indeed it's the severity and duration of this current episode, now approaching 48 hours, that makes me fear a progressive neurological syndrome -- plus he has chronic pain)

and if cocaine-induced hypokalaemia is indeed what has been happening to my friend, then it's good news -- i.e., it's neither a congenital condition or a progressive neurological disorder -- he needs only to quit partying

i'll see what the doctors have to say

dominic
01-05-2005, 01:03 AM
actually they think he has tuberculosis

and that the disease attacked his spine (pott's disease)

so they'll need to operate on his spine

cocaine use resulted in periodic paralysis by depriving the spinal column and bone joints of liquid or some such explanation

of course now i wonder if i have tuberculosis, i.e., the disease may lie dormant for many many years

my friend was presumably infected with tuberculosis many years ago

according to wikipedia tuberculosis is the most common major infectious disease today -- roughly 2 billion people are infected = 1/3 of the world's population

borderpolice
01-05-2005, 02:35 PM
i'd also consider the possibility that it's a damaged back that's causing the problems. If a disk slips,
if it gets into the spinal channel, it may touch nerves causing signals being sent (or not sent) which
the brain interpretes as if they were coming from the legs. numbness in the legs is a popular
symptom of this. it's probably not the (sole) cause of your friend's problems, but it's something to
consider, to ask the medics to check out.

Canada J Soup
04-05-2005, 04:17 PM
now i wonder if i have tuberculosis

If someone you know has TB and you've been exposed to them for extended periods (esp. if they've been crashing on your couch) the chances of infection are high. It may never become active though, as the bacteria that causes TB stays dormant in about 90% of people who are infected. There is a course of antibiotics that can used to treat dormant TB, but it involves taking a pill a day for something like six months so it's kind of a pain in the ass.