Talk:Parkinson's disease/Archive 2

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Hydrocephalus

Symptoms of Parkinson's Disease, most commonly gait disorders, can often occur simultaneously with Hydrocephalus [1,2,3], and can be due to the effects of Hydrocephalus [2,4,5,6]. The Parkinson's Disease symptoms may be caused by increased intracranial pressure reducing blood flow to the basal ganglia where dopamine is produced [6].

[1] Journal of neurology, neurosurgery and psychiatry [2001] 70 (3) : 289-297 (H.Stolze, J.P.Kuhtz-Buschbeck, H.Drucke, K.Johnk, M.Illert, G.Deuschl)

[2] Movement Disorders [1997] 12 (1) : 52-60 (J.K.Krauss, J.P.Regel, D.W.Droste, M.Orszagh, J.J.Borremans, W.Vach)

[3] Movement Disorders [1994] 9 (5) : 508-520 (T.Curran, A.E.Lang)

[4] Movement Disorders [1986] 1 (1) : 59-64 (J.Jankovic, M.Newmark, P.Peter)

[5] Canadian Journal of Neurological Science [1985] 12 (3) : 255-258 (L.Berger, S.Gauthier, R.Leblanc)

[6] Pediatric Neurology [1988] 4 (2) : 117-119 (E.Shahar, R.Lambert, P.A.Hwang, H.J.Hoffman)

Unsigned by Gerard Doyle (talk · contribs), 30 September 2006, 20:00

If you use this approach you will need to include many more diseases. In practice, all these diseases are excluded almost instantly on the basis of clinical history alone. For instance, a lacunar infarct of the basal ganglia would also produce a movement disorder, but seldomly without other lateralising signs. It would also be sudden-onset rather than insidious. I think the hydrocephalus issue should be removed until you can prove that it is part of a neurologist's differential diagnosis for Parkinson's. The implications are obvious. Hydrocephalus is diagnosed by fundoscopy, CT scan and lumbar puncture. Are you suggesting all Parkinson's patients should undergo this? No, that is not supported by the evidence you have provided. Please try harder, Gerald. JFW | T@lk 19:36, 30 September 2006 (UTC)

1. "If you use this approach you will need to include many more diseases." This is incorrect as there are only about a dozen disorders that can cause Parkinson's Disease symptoms. You have only given one additional disorder. One is not "many more".

2. Am I suggesting that all people with PD should be diagnosed by Hydrocephalus methods ? No and it's not even implied or necessary according to the inclusion of Hydrocephalus. The implications are irrelevant anyway. What somebody doesin response to this information is up to them. Hydrocephalus occurs from an early age, whereas PD usually doesn't. So by the time of a PD diagnosis Hydrocephalus would usually be known. The practical relevance of this information is that if somebody showed the symptoms of PD and already had Hydrocephalus that the PD symptoms could be due to Hydrocephalus rather than PD.

3. The sole question is whether Hydrocephalus can cause symptoms of Parkinson's Disease. According to the published scientific literature it can occur quite frequently. What this implies is irrelevant. What some neurologists have previosuly thought about thisis irrelevant. The published scientific literature is overwhelming.

--Gerard Doyle 19:54, 30 September 2006 (UTC)

1. Don't cloud the issues. Demyelination, toxoplasmosis and AIDS encephalopathy will all produce movement disorders if the right area is targeted.
2. You give all the reasons why we should not list hydrocephalus, just as much as we should not list all the examples I've given in #1.
3. That is not the sole question. What we're trying to present here is a reasonable differential diagnosis for PD, and hydrocephalus is not amongst them according to most general sources. PMID 15489399 and PMID 7990846 suggest that this is a pretty rare clinical scenario; as the present article is aimed at the general public we should avoid "zebras" unless this is absolutely relevant (e.g. if that "zebra" led to elucidation of the pathophysiology, as sometimes has happened in other diseases). JFW | T@lk 20:54, 30 September 2006 (UTC)

1. Most movement disorders are not Parkinson's Disease. So examples of disorders that cause movement disorders are not examples of medical disorders that cause PD symptoms. So your examples are irrelevant. There is no number limitation anyway on the number of disorders.

2. "Hydrocephalus is not amongst them according to most general sources. PMID 15489399 and PMID 7990846 suggest that this is a pretty rare clinical scenario". You have cited irrelevant published scientific literature that only details isolated cases. They do not assess the frequency of hydrocephalus. The research I referred to shows that it is quite a common occurrence. There is also not a cut off point regarding frequency anyway.

--Gerard Doyle 21:37, 30 September 2006 (UTC)

1. Just look it up. Parkinsonism can be caused by all these. I can think of number of others, but I won't wear you out.
2. Irrelevant? One of them was cited by yourself! Could you give the PMID codes for your other references? Are you suggesting hydrocephalus-induced parkinsonism is common? JFW | T@lk 22:21, 30 September 2006 (UTC)

The full references are given and so should be easy to find on PubMed by typing hydrocephalus and the author surnames. The PD symptoms are proven in these studies (1) to occur as a result of the Hydrocephalus and not just simultaneously with it, and (2) to often occur as a result of it. Medical disorders are not Parkinsonism disorders if (1) they only cause symptoms of movement disorders rather than Parkinson's Disease, (2) and merely occur simultaneously with Parkinson's Disease rather than cause its symptoms. Hydroephalus fulfills any reasonable definition of Parkinsonism. --Gerard Doyle 12:38, 1 October 2006 (UTC)

Parkinsonism is when a medical disorder can cause symptoms of Parkinson's Disease. By reading the above references it is very obvious that Hydrocephalus fulfills this definition.

Parkinsonism is NOT when a medical disorder can cause symptoms of Movement Disorders rather than Parkinson's Disease. Parkinsonism does not have to inevitably cause symptoms of Parkinson's Disease in all cases. Parkinsonism is NOT when a medical disorder merely coincides with Parkinson's Disease without actually causing it.

There have been reverts of this fact by Ryulong and PaulWicks without prior discussion or reason. Further reverts that are made concerning this without first justifying them on the Discussion page will be considered as blocking.

--Gerard Doyle 13:17, 2 October 2006 (UTC)

You misunderstand "blocking". Blocking is when you're locked out of Wikipedia, like I did to you a little while ago.

You are pushing this hydrocephalus thing a bit too hard. Have you considered all my other examples?

I will not remove the hydrocephalus stuff again, unless several other editors agree with me here that it should be removed (also known as consensus). If that is the case, you will need to stop inserting it. Paul Wicks has already made his views clear by reverting you. Consensus means you sometimes need to move away from something you regard as important, because this is how Wikipedia works. JFW | T@lk 20:24, 2 October 2006 (UTC)

I don't see the point in having hydrocephalus in this article. As Bridgeman was fond of pointing out, the article needs to be concise and to the point, and including a disorder that can occassionally cause symptoms resembling PD isn't useful. The same applies for hemochromatosis. --Dan 20:30, 2 October 2006 (UTC)

Copied by Gerard Doyle from talk page :

If some textbook editors didn't know about it it should under no circumstance be in Wikipedia. Indeed, I was unaware of the link between hydrocephalus and PD, but a cursory examination of the relevant literature confirmed that this is a rare cause of Parkinsonism (not Parkinson's disease!) that need not be mentioned in a general purpose encyclopedia.

What people do you know that can judge this article? If they are truly qualified to do so, couldn't they help out a little? JFW | T@lk 20:31, 2 October 2006 (UTC)

Due to my past work and my contacts, I know many people involved or connected with Parkinson's Disease in different respects. I do not know of even one of them that has any regard for the Wikipedia Parkinson's article. It is too badly organised, inconsistent, contains too many errors and inadequacies, contains too many fanciful theories.

The major change that should be made to the article is what it appears PaulWicks has been proposing for quite some time, which is to have paragraph summaries on the Parkinson's Disease page, with links to sub articles on each of the subjects such as symptoms, epidemiology, treatments, pathology, causes (toxins, genetic, etc), history, etc.. PaulWicks appears keen to start up a sub-article on symptoms and also treatments. You have an epidemiologist who could link to and expand epidemiology in a sub article.

1. "If some textbook editors didn't know about it it should under no circumstance be in Wikipedia." - Unfortunately, most textbooks, and I have read many, are very badly written. They are usually full of horrendous omissions and inadequacies.

2. "I don't see the point in having hydrocephalus in this article. The article needs to be concise and to the point." - If Parkinsonism was merely summarised on the Parkinson's article and linked to a sub article on Parkinsonism, then Hydrocephalus would take up only one word.

3. "You are pushing this hydrocephalus thing a bit too hard. Have you considered all my other examples?" Rarer causes are ceratinly not unimportant to those that have them ! There are millionsof people with rare causes of medical disorders. I haven't carried out a detailed assessment of the entire scientific literature concerning the additional medical disorders you mentioned, but I may. If there is evidence that those disorders can CAUSE Parkinson's Disease symptoms rather than merely coincide with it, or merely cause other movement disorders, then they are forms of Parkinsonism and should be listed.

--Gerard Doyle 21:18, 2 October 2006 (UTC)

1. To restate my question: could you involve any of those past contacts to improve a vitally important public resource, the 14th most popular website in the world? Preferably someone with an academic background and practising neurology.
2. If we cannot believe the textbooks, then who are we to believe? Dr Gerald Doyle, recipient of the Nobel Prize for the first cure for Parkinson's? Honestly, what source are you expecting us to rely on apart from your personal judgement? Does everyone agree that whatever was left out amounted to "horrendous omissions and inadequacies", or is that your personal view?
3. Parkinsonism should list all causes of that constellation of symptoms. You can list your hydrocephalus there with appropriate references, as it does not cause Parkinson's disease and is rarely entertained as a differential diagnosis for PD (as opposed to Wilson's, which is, given the propensity of neurologists on ordering copper studies for young PD patients).
4. None of the causes I listed cause classical Parkinson's disease; they can cause Parkinsonism if the appropriate part of the basal ganglia is involved. The same goes for your hydrocephaus.
5. I register several other editors opposing the hydrocephalus info. Paul Wicks, Dan Snow, and myself now oppose it. We should have a few more days of discussion on this, but at the moment you seem to be a dissenter. Please respect consensus when we finally tally the votes. I'm happy for this to go to WP:RFC if you think this will improve matters. JFW | T@lk 22:41, 3 October 2006 (UTC)

1. I know a lot of people in many different countries of different scientific backgrounds, neurology, biochemistry, doctors, pharmacology, pharmacy, numerous people with Parkinson's Disease. Between them they have published thousands of studies. However, it is not that easy to get busy people to spend their time on something that somebody else may later wipe out based on a whim, or that may be objected to without valid reason.

2 If we cannot believe the textbooks, then who are we to believe ? The only really reliable source of information is to go to the original sources - the published research, because these are the building blocks of scientific knowledge. Given that the smallest of subjects can require checking hundreds or even thousands of abstracts, authors just don't do it. They instead often rely on hearsay or what they think is common knowledge, which often isn't even true. Even published research must be examined sceptically because : most medical research is useless, most conclusions don't match the results, many results are not reliable because of inadequate methods. My method for any issue is to go through all potentially related research on PubMed. Check the complete papers where it is needed. Ask if it is relevant. Ask if it is true, to what extent is it true, are the methods reliable, is it consistent with other known facts.

3 and 4. Hydrocephalus would be known long before somebody would be likely to get Parkinson's Disease symptoms. So in assessing PD somebody would not need to be assessed for Hydrocephalus. The practical significance of Hydrocephalus is that somebody would know that they had Hydrocephalus first and could later get the symptoms of Parkinson's Disease. They could of course happen to have both, but the research shows that the symptoms can be the result of Hydrocephalus and can be rid by treating it as Hydrocephalus rather than Parkinson's Disease.

5. If three editors believe that George W.Bush is Bulgarian and one editor believes that he isn't, does that make him Bulgarian ? Fully substantiated scientific fact is on my side. If somebody doesn't accept scientific fact then they are not being logical or scientific. I might not have all opinion on my side, but far more importantly, I certainly have all scientific evidence on my side. I'm still waiting to see any opposing evidence. If opposing opinions are maintained despite the complete lack of any opposing evidence, then as a matter of principle, I will take it through all the further assessment procedures.

--Gerard Doyle 11:29, 4 October 2006 (UTC)

1. I got a professor to review coeliac disease (or rather instruct one of his researchers to do so). That required two emails. Surely you could use your influence to mobilise someone useful? Serious recommendations with someone with verifiable scientific authority are usually not "wiped out on a whim" without a degree of consensus.
2. What original paper suggests that hydrocephalus should be considered in the differential diagnosis of classical Parkinson's disease? Full reference please. Has that paper, in turn, been cited and achieved acceptance?
3. You have answered your own question. If someone with hydrocephalus develops Parkinsonism, the diagnosis is less likely to be classic PD! Why are you still pushing for hydrocephalus to be mentioned here rather than on Parkinsonism, where it belongs according to your own logic?
4. Yes. If consensus emerges that GWB is Bulgarian, then the article will represent this, unless the minority then calls for RFC or other forms of dispute resolution. Scientific evidence yields to consensus on Wikipedia - get used to it. JFW | T@lk 22:49, 5 October 2006 (UTC)

I can get just about any information or input on Parkinson's Disease. However, there would inevitably be delays with some information because people such as the consultant neurologist I know are inundated with work. I know an internationally known pharmacologist who is called in as expert for many international authorites. However, he travels so much around the world that it is hard to keep track of him.

Hydrocephalus certainly isn't Parkinson's Disease. All the symptoms of Parkinson's Disease do not occur in most people with Hydrocephalus. However, in many people with Hydrocephalus Parkinson's symptoms can occur by indirectly affecting dopamine formation. It therefore has a place in a PD article, even if it is merely mentioned and is dealt with more fully in a Parkinsonism article.

--Gerard Doyle 13:00, 6 October 2006 (UTC)

I challenge you to get any of your influential friends to review this article. So far, you haven't as much as dropped a name.

You have not addressed my question: given that hydrocephalus is not a cause of PD and not really useful as a model for studying PD. What is it still doing in this article? JFW | T@lk 23:11, 8 October 2006 (UTC)

I don't really like to give out other people's personal details on the Internet because information is so readily available on the Internet to anyone. I would then have to specifically request their permission to openly quote them. People become a lot more inhibited if they know that what they write will be made public.

The standard of some of the people I know is very high. For example, Professor Beckett OBE who I know very well and for many years has published over 600 research papers. He has about six doctorates including DSc's. He was the chief scientific adviser for the International Olympic Committee, the IAAF (Athletics World governing body), the head of the Royal Pharmaceutical Society, and many more. He has taught more PhD students than anyone in the medical professions. I can't remember all his achievemnets as there are so many. There are others besides him that are nationally or internationally known in their areas.

However, one person reviewing this article is not appropriate. Parkinson's Disease as with most medical disorders is a wide range of subjects - anatomy, biochemistry, physiology, toxicology, pharmacology, pathology, epidemiology, medical history, etc. You will never get one expert opinion on all of it, but I can guess, given his standards and his straightforwardness how harshly Professor Beckett would criticise this article.

There is alo the problem of anyone adding even one single word to this article ends up with endless discussion, and investigations of the authors - everything short of referring it to the UN General Assembly !

"You have not addressed my question: given that hydrocephalus is not a cause of PD and not really useful as a model for studying PD. What is it still doing in this article?"

It is not Parkinson's but Hydrocephalus is often a cause of Parkinson's Disease symptoms. The references I have provided prove that. It is not a model for studying PD but it doesn't have to be. Forms of Parkinsonism should certainly at least be listed on a PD article. What is your criteria for a disorder being listed as a form of Parkinsonism ? I expect any reasonable criteria you give to either include Hydrocephalus or to exclude a disorder that you think should be listed.

I expect majority opposition to the inclusion of hydrocephalus, but I have yet to see any consistent scientific information at all that supports that view. --Gerard Doyle 01:27, 9 October 2006 (UTC)

I'm sure the UN General Assembly is too busy with Korea to worry about Gerard Doyle. Are you going to send that email to prof Beckett? You haven't actually told us whether he's see the article, so we cannot presuppose his response.

This article should not contain all causes of Parkinsonism. That includes your hobby horse hydrocephalus. The only causes that should be listed are the ones that are genuinely part of the "standard" differential diagnosis (such as Wilson's disease), or those that have served as useful models in the study of PD (e.g. lesion studies). Failing that, they're out. I hope this is clear enough. I have stated the same a couple of times now, if only you'd care to read what I wrote. JFW | T@lk 21:27, 12 October 2006 (UTC)

Useful source

Clinical evidence has a (2004) monograph on PD that may assist us in citing the right sources. JFW | T@lk 21:18, 30 September 2006 (UTC)

Hemochromatosis

While we're on the topic of "related diseases," I've noticed that hemochromatosis was recently added [1]. I'm not sure if this entity is necessarily worth including, for more or less the same reasons that hydrocephalus should not be included. Andrew73 16:54, 1 October 2006 (UTC)

This claim is only based on one citation in which a few cases of haemochromatosis were merely found simultaneously with Parkinson's Disease. More extensive examination showed that haemochromatosis did not cause Parkinson's Disease. Many medical disorders can occur simultaneously without being responsible for their cause. --Gerard Doyle 13:21, 2 October 2006 (UTC)

That is not to say there are no theories about iron toxicity in PD. JFW | T@lk 20:26, 2 October 2006 (UTC)

There are several reasonably-credible reports of an association between hemochromatosis and Parkinson's disease. E.g., Concurrent hereditary haemochromatosis and idiopathic Parkinson’s disease: a case report series. I'd have to go back to get the earlier cites, but I have known about it since the early 1970's, as a graduate student. It may be one of those things that everybody knows about, so it is not "reportable". If memory serves, present work on the involvement of iron in PD comes from this source. Pproctor 00:11, 6 October 2006 (UTC)

Parkinsonism

At present, Parkinsonism is being duplicated by being spread out over the following five articles :

• [Parkinson's disease]]
• Parkinson's disease mimics
• Parkinsonism
• Parkinson plus syndrome
• Parkinson plus

I suggest that the Parkinsonism disorders be listed on the Parkinson's Disease article, and linked to one Wikipedia Parkinsonism article that gave summary details of each of those disorders. --Gerard Doyle 19:46, 5 October 2006 (UTC)

Uhh, I agree that "PD mimics" should be merged with Parkinsonism. I feel the seperate article "Parkinson plus syndrome" should remain, as this is a container term that needs to be dealt with independently. Finally, Parkinson-plus is a redirect - I'm not sure why you included it. JFW | T@lk 22:52, 5 October 2006 (UTC)

If information is too spread out it will not get read. The Parkinsonism article could incorporate Parkinson Plus. When you examine the biological differences between them, I'm not sure what differences there that justifies them being kept completely apart. --Gerard Doyle 13:05, 6 October 2006 (UTC)

Based on recent attempts on James Parkinson to get a link into Viartis.net followed by a "mundane" edit by Gerard Doyle I am increasingly convinced of his GT-ness. I don´t want to enter into conversation with him until the checkuser comes back. --PaulWicks 08:36, 7 October 2006 (UTC)

Is a SP anyone who doesn't completely agree with you ? Isn't it merely a means of trying to overcome opposing views when you can not overcome them using reasoning and facts ? --Gerard Doyle 12:50, 7 October 2006 (UTC)

The activities have all of the stigmata of a GT sock puppet (though I'm surprised at the incredible restraint in not using boldface). I'm not sure how reliable the check user would be, given that GT has been using domains in the Middle East. Andrew73 17:38, 7 October 2006 (UTC)

Guys, I've been trying to WP:AGF with Gerard. Let's try to disagree on issues. Have you all given your opinion on whether hydrocephalus needs to be mentioned? JFW | T@lk 23:13, 8 October 2006 (UTC)

I already assume being outnumbered by at least 3 to 1 despite being scientifically correct. If a majority of Wikipedia editors believe George W.Bush to be Bulgarian, then Bulgarian he shall be. --Gerard Doyle 11:21, 9 October 2006 (UTC)

This 'x is Bulgarian' argument is one of GT's classic arguments. GD equals GT. So good faith is no longer assumed by me. --PaulWicks 10:07, 10 October 2006 (UTC)

Agree with Paul - banned users, especially one of Bridgeman's ilk, simply should not be posting. Hydrocephalus rarely can cause Parkinson's-like symptoms, and in that case, so what? It's obvious to the diagnosing clinician what's going on, and there's really no light shed on PD etiology or treatment thereby, since the tx is to treat the hydrocephalus. It's irrelevant, and the discussion has gone on way too long. But that's typical pointless Bridgeman argumentation. --Dan 15:14, 10 October 2006 (UTC)

I agree with Dan's reasoning that including hydrocephalus doesn't add that much to the article. Andrew73 00:31, 11 October 2006 (UTC)

Thank you, everyone. I have now removed the hydrocephalus stuff. JFW | T@lk 21:29, 12 October 2006 (UTC)

1. "Hydrocephalus rarely can cause Parkinson's-like symptoms" FALSE - It often causes PD symptoms, as is proven by the references provided.

2. "There's really no light shed on PD etiology or treatment" IRRELEVANT - There doesn't have to be in order to be considered as a form of Parkinsonism. None of the forms of Parkinsonism provide any more information about etiology and treatment than does Hydrocephalus. So are you going to remove all the rest ? Of course you won't despite the blatant inconsistency of the objection.

2. "Hydrocephalus doesn't add that much to the article" INCONSISTENT - It doesn't have to add much in order to be added. Most elements of the article do not in themselves add much. Qijong certainly does't add much if anything at all, yet it gets two paragraphs ! Obvious inconsistency there.

I see negative conclusions but nothing at all to back it up. The response has been very unscientific. So I will take the assessment of this issue further before more qualified people, so that a logical and scientific conclusion is reached.

All of the forms of Parkinsonism should be dealt with under Parkinsonism. However, they should all at leat receive a mention on the Parkinson's Disease article, even if it is just one word, otherwise people wouldn't even be aware of them in order to get more information on the Parkinsonism article.

The Parkinson's Disease article is probably at present the worst medical article on Wikipedia. Anything beyond trivial is reverted or falsely described as vandalism. Significant improvements are never made. It is very badly organised. Most of it is not susbtantiated, and never could be. Much of it is worse than it was months ago. Amongst people I know that have or are involved in Parkinson's Disease it is completely discredited due to its numerous fallacies, inadequacies and inconsistencies. Nobody I know thinks it even worth using it. Until there is a fundamental change in attitudes amongst those people that have chosen themselves as editors that is exactly how it will remain.

--Gerard Doyle 21:51, 12 October 2006 (UTC)

I would suggest, therefore, "Gerard", that you go and do your own site, so you can do it to your own satisfaction and standards, and leave us to our collective incompentence. --Dan 22:18, 12 October 2006 (UTC)

Well "Dan", I don't think it fair of you to describe your own efforts as "incompetence" because when added up you have hardly added anything in order to be incompetent. On most articles people make their contributions and move on. Instead, you don't make contributions yet still linger. If you have something to add, why haven't you added it. If you don't have anything to add, why are you still hanging around ? I am really baffled by this. --Gerard Doyle 23:59, 12 October 2006 (UTC)

More on hydrocephalus

I think Dan, Paul, Andrew and some others are waiting for the evidence that you are not a Tojo sock, so they will find it a tad easier to WP:AGF, like I have attempted to do without much positivity from you (e.g. I unblocked you despite strong negative vibes).

To respond to your above further hydrocephalus rant:

1. Be honest: how many cases of hydrocephalus are complicated by parkinsonism (don't refer us to the sources, I want a figure straight from you).
2. Can you cite us one scenario where the pathogenesis of Parkinson's disease (not "parkinsonism") has been elucidated significantly due to findings related to hydrocephalus?
3. Hydrocephalus doesn't add that much to the article. I stand behind that statement; it adds less to the article than MPTP. I have already outlined above that hydrocephalus requires no mention if it is not part of the "general" differential diagnosis of PD and doesn't shed light on its pathogenesis. These are simple principles that other editors will agree with. I fail to understand why you're pushing so hard in the absence of really good grounds for inclusion.

As stated, good articles grow by consensus. Please propose further significant changes here on the talkpage, and honour consensus when it emerges. Even the thorniest articles have been featured when opposing groups of editors managed to produce a consensus. JFW | T@lk 00:18, 13 October 2006 (UTC)

1. "Hydocephalus resulting in Parkinson's symptoms ?" - The references have already been provided.

2. "Hydrocephalus showing how Parkinson's is caused" - It doesn't have to show how Parkinson's is caused in order to be a form of Parkinsonism. Wilson's Disease doesn't yet you still list it.

3. "Hydrocephalus doesn't add much." - It doesn't have to in order to be included. Two paragraphs for Qijong !!! That doesn't add anything at all.

This isn't a discussion. All this involves is people trying to maintain the view they started out with regardless of how false or inconsistent it is. Opposing evidence is ignored. When one objection fails another is tried.

The article has not grown at all due to consensus. It hasn't grown, it has gotten worse. At present there are four persistent editors, none of whom have any expertise in Parkinson's Disease. None of them are neurologists, PD sepcialists, or have Parkinson's. They never add anything of any significance. They all agree with whatever each other suggests regardless of how blatantly false it is. They obstruct or revert any significant changes, all of which they spuriously describe as vandalism. Absolutely anyone who makes any significant changes is labelled a Sock Puppet- claimsthat often have to be subsequently reversed. In some cases you would really have to stretch the imagination to work out why. I was recently part of a thorough checkuser assessment. So I don't have to prove anything. Anyone who disagrees is described as negative or obstructive. The sum result of this is that the article is presently awful, full of errors, inconsistencies, inadequacies, and fanciful theories.

The reason why I persist with Hydrocephalus is that persistence is the only way any improvements will be made to this article. There are so many improvement that are needed, but it is obvious that every single one of them will be objected to without good reason.

It is now time to bring in people with more expertise in this subject in order to overcome the constant obstruction by this small majority of obviously allied editors, all of whom lack expertise in this subject. It is also time to bring to the attention of other Administrators how much obstruction is taking place.

--Gerard Doyle 12:29, 13 October 2006 (UTC)

I do have to begrudgingly agree with Doyle's point about the inclusion of qijong in previous edits. I can see his point that if qijong is going to be included, why not hydrocephalus? On the other hand, both qijong and hydrocephalus have the flair of "pet topics" favored by individual users rather than consensus.

Ultimately, the reason why this has been a difficult discussion is that, alas, any contribution by a Tojo sock puppet is viewed with extreme prejudice, and why would it not be, given his previous antics and drama.

(Incidentally, contrary to Doyle has been suggesting [2], I don't think that check user has actually exonerated Doyle from being a sock puppet. Now whether or not all Tojo sock puppets should be categorically barred from contributing is a separate matter.) Andrew73 13:23, 13 October 2006 (UTC)

"I don't think that check user has actually exonerated Doyle from being a sock puppet." It hasn't exonerated you either !

The following is the rational, consistent, concise and comprehensive approach :

Physical exercise

Regular physical exercise and/or therapy, including in forms such as yoga, tai chi, Qijong [reference - not two paragraphs !] and dance can be beneficial to the patient for maintaining and improving mobility, flexibility, balance and a range of motion.

Parkinsonism

Other medical disorders can sometimes cause some or all of the symptoms of Parkinson's Disease. These include Wilson's Disease, Vascular Parkinsonis, Essential Tremor, Hydrocephalus, etc, ect. For full article see [link to Parkinsonism].

--Gerard Doyle 13:35, 13 October 2006 (UTC)

The reason why there is two paragraphs on qiqong is not because it is a pet theory of mine. The reason is that you (or whichever account you were using, my mind grows weary) deleted it out of hand because you said it was unsourced. So I went and found some recent, relatively sound studies stating what the evidence was. If only you would act like this instead of reverting, deleting, wikilawyering, and being abusive, perhaps you would have been taken more seriously in the past. But the truth is this: as GT and his various incarnations you were disruptive, abusive, and made physical threats against editors. You are banned. So feel free to say whatever you want on viartis.net or dopavite.com, heck even Braintalk 2. But on Wikipedia there are rules. You violated them, so you're not welcome. --PaulWicks 16:02, 13 October 2006 (UTC)

It was good to have found the evidence concerning Qijong. However, it is excessive to include two paragraphs on something like Qijong. References (for example [17]) are appropriate. That is what is done throughout the rest of the article when providing evidence, but with Qijong has not been done.

Jfdwolff asked "Please propose further significant changes here on the talkpage" yet has just made changes without adhereing to his own request. That is solely the reason for the recent revert. Rules and customs should apply equally to everyone.

Due to the investigation that has been initiated, you will soon be finding out from Administrators that you are breaching the very rules you claim should be adhered to. Besides risking sanctions yourself, it will not look good if you intend to apply to be an Administrator again. --Gerard Doyle 16:22, 13 October 2006 (UTC)

EDIT HISTORY : PaulWicks for three months, from July to October

Reverts and deletes : 22

Contributions : two paragraphs on Qijong !

The record shows that you don't actually contribute anything. If you have something to contribute, why don't you add it ? If you have nothing to contribute, why are you lingering endlessly ? Most genuine editors make their contributions and then move on to the next article. --Gerard Doyle 16:11, 14 October 2006 (UTC)

I think this troll-feeding has gone on long enough. Bye Keith. --PaulWicks 21:48, 14 October 2006 (UTC)

I'm really baffled. Why do you always linger around a site that you never contribute to ? --Gerard Doyle 22:31, 14 October 2006 (UTC)

Vascular Parkinsonism

Vascular parkinsonism is produced by one or more small strokes that affect the basal ganglia. A stroke is the loss of activity of a discreet brain area (lesion) because of blockage of the blood supply to that brain region. Vascular diseases are associated with a higher prevalence of Parkinson's Disease [1]. There are three different pathologic states that produce Vascular Parkinsonism (VP), including multiple lacunar infarctions in the basal ganglia area [2,3], subcortical arteriosclerotic changes (Binswanger's disease) [2,3] and a single vascular lesion that present a clinical picture indistinguishable from Parkinson's disease [2,3,4]. Parkinson's Disease symptoms occur in Vascular Parkinsonism [5-12]. However, resting tremor is either reduced [5,6], or absent [7,8]. Only a minority, but a large minority, of people with Vascular Parkinsonism respond to L-dopa [9,10].

[1] Archives of Neurology [2006] 63 (5) : 717-722 (E.D.Louis, J.A.Luchsinger)

[2] Journal of Neurology [2006] 253 (Supplement 3) : iii16-iii21 (K.Fukimoto)

[3] Journal of Neurology [2004] 251 (5) : 513-524 (I.Sibon, G.Fenelon, N.P.Quinn, F.Tison)

[4] Journal of Clinical Neuroscience [2001] 8 (3) : 268-271 (S.Peters, E.G.Eising, H.Przuntek, T.Muller)

[5] Di Yi Jun Yi Da Xue Xue Bao [2005] 25 (7) : 868-870 (D.Q.Zhao)

[6] Archives of Neurology [1999] 56 (1) : 98-102 (J.Winikates, J.Jankovic)

[7] Acta Neurologica Scandinavica [1992] 86 (6) : 588-592 (C.M.Chang, Y.L.Yu, H.K.Ng, S.Y.Leung, K.Y.Fong)

[8] Stroke [1997] 28 (5) : 965-969 (H.Yamanouchi, H.Nagura)

[9] Journal of Neurology [2005] 252 (9) : 1045-1049 (LRampello, A.Alvano, G.Battaglia, R.Raffaele, I.Vecchio, M.Malaguarnera)

[10] Journal of Neurological and Neurosurgical Psychiatry [2004] 75 (4) : 545-547 (J.C.Zijlmans, R.Katzenschlager, S.E.Daniel, A.J.Lees)

[11] Acta Neurologica Scandinavica [2001] 104 (2) : 63-67 (M.Demirkiran M, Bozdemir H, Sarica Y.)

[12] Movement Disorders [1996] 11 (5) : 501-508 (J.C.Zijlmans, P.J.Poels, J.Duysens, J.van der Straaten, T.Thien, M.A.van't Hof, H.O.Thijssen, M.W.Horstink)

--Gerard Doyle 21:12, 14 October 2006 (UTC)

You have already been informed that causes of parkinsonism should not be listed here unless part of the GENUINE differential diagnosis of Parkinson's disease. Just listing papers will not help you - this shows that you are good at copying & pasting from an inexhaustible list of articles. You can't even be bothered to list the names of papers or their PMID code. All other editors manage (or at least try) to do that. JFW | T@lk 19:33, 15 October 2006 (UTC)

Manganese and Pproctor

Gerard is right, I should have explained here why I removed the section about manganese poisoning. It's for the same reason his own work gets reverted: it is not common, does not normally form part of the differential diagnosis of PD, and furthermore it is the work of an editor who likes to link to his own website to support his edits. There were no objections when I removed it earlier (apart from Gerard), so I suspect my repeated removal will be accepted without much problems. JFW | T@lk 19:33, 15 October 2006 (UTC)

Sprotection

AjaxAmsterdam (talk · contribs) deleted a paragraph in the "toxic causes" section with no explanation. I have reverted for now. If we get further new/red user vandalism I suspect we'll need to get the article semiprotected again. JFW | T@lk 22:37, 16 October 2006 (UTC)

External links review

Just checking up on the article and I noticed that the External links section has grown out of control. I've removed all of the following links:

• European Parkinson's Disease Association
• Parkinson Society Canada
• Parkinson's Disease Foundation
• Parkinson's Action Network
• Hope For A Cure Foundation for Parkinson's Research
• Dr. Abe Lieberman's Ask the Doctor Parkinson Forum
• National Parkinson Foundation, Inc.
• American Parkinson's Disease Association
• Michael J. Fox Foundation for Parkinson's Research
• Parkinson's Disease Society (UK)
• Parkinson's NSW (In AUS)
• 'Investigating Parkinson's Disease' Dr Brigit Liss Freeview 'Snapshots' video by the Vega Science Trust and the BBC/OU.
• MyParkinsonsInfo.com
• The PD Webring
• WEMOVE: Worldwide education and awareness for movement disorders
• NETRP Web site
• Northwest Parkinson's Foundation
• Parkinson's Resources on the WWWeb
• Parkinson's Disease Pictures
• Parkinson's Drug Comparison Chart (PDF)
• International Society for Posture and Gait Research (ISPGR)
• HollyRod Foundation
• Lee Silverman Voice Therapy

and replaced them with a link to the Open Directory Project (formerly Dmoz) which suggests editors submit their links there and {{NoMoreLinks}} to force new editors to post new links here for review first. So what links should this article contain as an encyclopedia article and not a web directory per the Wikipedia:External links policy? --  Netsnipe  ►  20:01, 23 October 2006 (UTC)

Interesting question. This is not an advocacy site, of course, but laypeople may well come here for further information, and might appreciate having links to further information. I suspect that's the thinking behind the lists of links, but I agree with your point that this is an encyclopedia, and there are plenty of link farms out there on the net. So as an encyclopedia, what would be best? I dunno, maybe a link to current review articles such as the extanisve UK government review on toxins & PD (don't have the URL handy, sorry - it's in VOLUME 114 | NUMBER 2 | February 2006 • Environmental Health Perspectives, and is about 170 pages long. Or a research consortium site, like CCPDER? Links make me uneasy - it's altogether too easy to get into spamming problems. --Dan 22:39, 23 October 2006 (UTC)

Web sites can serve two purposes : practical assistnce for patients, or more extensive information on Parkinson's Disease.

Practical information is offered by the national or international Parkinson's Disease organisations. Most countries have one and are listed on either the World or European sites. The USA has four, some of which are not affiliated to the World organisation. The following therefore covers by at least one means all of the national and international organisations :

• World Parkinson's Disease Association
• European Parkinson's Disease Association
• Parkinson Society Canada
• Parkinson's Disease Society (UK)
• American Parkinson's Disease Association
• Parkinson's Disease Foundation
• Parkinsons Research Foundation
• National Parkinson Foundation, Inc.

The following is accounted for by the Parkinsons Research Foundation and so need not be included :

• Dr. Abe Lieberman's Ask the Doctor Parkinson Forum

The Michael J.Fox site is not one of these organisations, but due to its renown some people may consider it worth including :

• Michael J. Fox Foundation for Parkinson's Research

The following adds more information on Parkinson's Disease drugs than exists in the article :

• Parkinson's Drug Comparison Chart (PDF)

The rest add nothing to the article, as they are either for fundraising, dead links, lesser sources of information on Parkinson's Disease, only regional organisations or odd treatments :

• Parkinson's Action Network
• Hope For A Cure Foundation for Parkinson's Research
• Parkinson's NSW (In AUS)
• 'Investigating Parkinson's Disease' Dr Brigit Liss Freeview 'Snapshots' video by the Vega Science Trust and the BBC/OU.
• MyParkinsonsInfo.com
• The PD Webring
• WEMOVE: Worldwide education and awareness for movement disorders
• NETRP Web site
• Northwest Parkinson's Foundation
• Parkinson's Resources on the WWWeb
• Parkinson's Disease Pictures
• International Society for Posture and Gait Research (ISPGR)asking
• HollyRod Foundation
• Lee Silverman Voice Therapy

--Professor Rizzo Naudi 23:57, 23 October 2006 (UTC)

Thanks for reviewing the links Naudi. The only one I haven't restored to the page is Michael J. Fox's Foundation. I have some reservations that including it will introduce a slippery slope with other advocacy groups arguing that it's unfair to exclude them while MJF's Foundation is listed. Thoughts? --  Netsnipe  ►  10:34, 24 October 2006 (UTC)

Personally I wouldn't include it because (1) it does not add further information that is not contained in the article, and (2) is not one of the national organisations. Some people will have a different opinion, and at some point other people will inevitably propose adding it, largely because it is well known. --Professor Rizzo Naudi 12:02, 24 October 2006 (UTC)

Then again it can easily be found through MJF's own entry on Wikipedia, and is eminently Googlable. So I don't think we detracting from anything here, and as you say there is the risk of a slippery slope. In something like ALS it's not such a big deal as there are only a handful of organisations worldwide. --PaulWicks 17:46, 24 October 2006 (UTC)

Hitler's PD

Media anthro (talk · contribs) removed mention of Adolf Hitler. Unfortunately media anthro is a new user, and was reverted by the VoAbot II (which watches this article). I think there is no concensus amongst "paleo-physicians" (doctors who like to diagnose illness in dead white men) that Hitler had PD, but some evidence is definitely present.

We have a whole article discussing Hitler's health at Adolf Hitler's medical health, which is a bit low on evidence. However, PMID 10053222 and PMID 1484538 go quite a way into strengthening the case. Perhaps we should indeed make the wording a bit more tentative. JFW | T@lk 09:44, 26 October 2006 (UTC)

Adolf Hitler definitely had Parkinson's Disease. His personal physician Dr Theo Morell kept diaries in which he kept full details all of Hitler's symptoms and treatments. Amongst a variety of illnesses and treatments, he had the symptoms of well progressed Parkinson's Disease, and was taking medicines that were used at the time for Parkinson's Disease. The diaries were published as "Adolf Hitler : The medical diaries" (Theo Morell). A documentary concerning Hitler's health called "Hitler : Dead men talking" shows film of Hitler's progressing Parkinson's Disease that first becomes apparent in 1933. Hitler's Parkinson's Disease was never disclosed publicly, and film that exists showing his symptoms was never used publicly. However, there is still a lot of film showing his symptoms. The last piece of film of HItler was when he inspected Hitler Youth outside his bunker just before he comitted suicide. There are actually two versions of this film - one that was made public that did not show his tremor, and another that was not made public that did show his tremor. --Professor Rizzo Naudi 13:44, 26 October 2006 (UTC)

Side Effects Of Drugs

Following the L-DOPA section, there is a section on dopamine agonists with the following line:

These have their own side effects including those listed above in addition to somnolence...

There is nothing listed "above" in that section or, as far as I can tell, in the L-DOPA section. I presume the general side effects would include hyperkinesias, and this should probably be stated. I'm not adding myself because I have no reference available. SJS1971 13:16, 1 November 2006 (UTC)

Tardive dyskinesias, hallucinations, and possibly dopamine dysregulation syndrome would be obvious ones to start with. Also there is a feeling that the sooner one starts dopaminergic medications the sooner their benefits will wear off. I'm a bit stretched for time at the moment, anyone else feel like having a crack at these? --PaulWicks 13:32, 1 November 2006 (UTC)

Surgery

When I found the article today, the surgery section seemed to underplay the research in this area. My own sense (but as an academic, not a medical professional) is that there is increasing excitement about pallidotomy and other surgical interventions. I have added just a small bit to the surgery section and provided references but would be happy to have someone else look over and add to it if justified. SJS1971 13:37, 1 November 2006 (UTC)

Glutathione deficiency and Parkinson's disease -- Cause and Treatment

Here a very interesting article on medlounge.org that talks about connection of glutathione with Parkinson's disease. This would be a great addition to Wikipedia's knowledgebase. (http://www.medlounge.org/articles/view/12.html)

Sorry, disagree. --PaulWicks 22:47, 16 November 2006 (UTC)

Good article

I found the article very informative and well written. Good job! Anagnorisis 01:06, 20 November 2006 (UTC)

Recent edits...

I've put back some of the references that were deleted in previous edits. Unless the references are wrong, why throw the baby out with the bathwater? Andrew73 00:00, 24 November 2006 (UTC)

I've asked Drbartlett (talk · contribs) to discuss removals of information first. I will need to remind him. JFW | T@lk 23:03, 25 November 2006 (UTC)

Brand names

An editor has favored deleting brand names from this article. I figured inclusion of brand names (e.g. Sinemet, Requip, etc.) makes the content more accessible, especially to a lay audience who may not necessarily be familiar with the generic names (though I agree that in an academic article, brand names would be out of place). Andrew73 04:18, 4 December 2006 (UTC)

I think main mention should be the generic (INN) names, but I think it is reasonable for 1st mentions to then include in brackets the the (singular) main brand name for the main countries of English Wikipedia (i.e. the brands that developed the drug and 1st marketed and presumably therefore had the longest and largest sales - so Australia/Canada/NZ/UK/US would seem appropriate - mostly same names across different countries of course). David Ruben ^Talk 04:27, 4 December 2006 (UTC)

There was a discussion in September @ Wikipedia_talk:WikiProject_Drugs#Drugs_and_brand_names on this topic. I've just found it, so I don't have a post-reading comment right now. Better to re-instate conversation on the topic over at the WikiProject, in my opinion. --User:Ceyockey (talk to me) 05:33, 4 December 2006 (UTC)

Genetics in under 40's

The Wikipedia editor that added the citation, which I have read, has incorrectly summarised its contents, as it does not actually provide the evidence that is claimed.--DavidLeslie 23:03, 29 January 2007 (UTC)

So could you tell us what the paper does say before you remove the reference? Please follow the advice I have left on your talkpage. JFW | T@lk 23:47, 29 January 2007 (UTC)

It provides no conclusive evidence in any respect. --DavidLeslie 00:08, 30 January 2007 (UTC)

I'm not familiar with the paper in question. However, Tanner is an author on another recent paper called "Nongenetic causes of PD." Also, there are recent studies emphasizing nongenetic factors:

Neurology. 2004 Jul 27;63(2):305-11. No evidence for heritability of Parkinson disease in Swedish twins. Wirdefeldt K, Gatz M, Schalling M, Pedersen NL. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

BACKGROUND: Although several genes are implicated in Parkinson disease (PD), they explain only a small fraction of cases. The etiology of most cases is yet unknown. OBJECTIVE: To evaluate heritability of PD in same-sexed and opposite-sexed twin pairs in the Swedish Twin Registry (STR). METHODS: All twins in the STR born in 1950 or earlier and alive in 1998 (n = 50,150) were included. The authors screened 33,780 twins in 14,082 pairs for PD by telephone interviews and linked the STR to the Swedish Inpatient Discharge Register. Two hundred forty-seven twins with self-reported PD or a PD diagnosis in the Inpatient Discharge Register (called "possible PD") and 517 twins who reported parkinsonian symptoms or use of antiparkinsonian medication ("suspected parkinsonism or movement disorder") were identified. RESULTS: For possible PD, there were only two concordant pairs, both female dizygotic. Similarly, concordances were low in all zygosity groups when the definition of affected was expanded to include twins with suspected parkinsonism or movement disorder in addition to possible PD. Sex differences in the relative importance of genetic and environmental effects were indicated with a marginally larger familial component in women. The best-fitting structural equation model included only environmental components of variance. CONCLUSIONS: These results suggest that environmental factors are most important in the etiology of PD. Compared with other complex diseases, the importance of genetic effects in PD is notably low. The preponderance of discordant twin pairs provides an ideal material for studying environmental risk factors and potential genotype-by-environment interaction.

I have not read this paper either, only this abstract. It seems reasonable I think to remove the comment about "entirely genetic". I'll await a consensus before removing the line myself. SJS1971 01:13, 30 January 2007 (UTC)

Thank you for adding this. It was also very recently shown that even genetic mutations concerning Parkinson's Disease do not cause Parkinson's Disease most of the time, as there are as many people with these genetic mutations that don't get Parkinson's Disease.--DavidLeslie 12:58, 30 January 2007 (UTC) Annals of Neurology [2006] Dec 22; [Epub ahead of print] (Kay DM, Moran D, Moses L, Poorkaj P, Zabetian CP, Nutt J, Factor SA, Yu CE, Montimurro JS, Keefe RG, Schellenberg GD, Payami H.)

Gambling

This may not be the right article, but several forms of dopamine agonism have been linked with a markedly increased risk of problem gambling. JFW | T@lk 01:03, 31 January 2007 (UTC)

External link to history of Parkinson's disease

Someone recently added a link about the history of Parkinson's disease (doiop\.com/jb788e - remove the \) to the History of medicine article. I looked at it, found it useful and interesting, and deleted it from that article because it seemed more appropriate here. However, I notice that the URL redirects to a site that has been blacklisted on Wikipedia. I leave it to the editors here to determine the usefulness of this link. -Amatulic 20:58, 6 February 2007 (UTC)

"Useful and interesting" is what Wikipedia is all about. Instead of History of medicine or Parkinson's Disease the most appropriate article for it would be the History of Parkinson's Disease. However, there doesn't seem to be an article concerning that subject. --Agfa4000 23:18, 6 February 2007 (UTC)

Actually, no. "Notable and Verifiable" is what Wikipedia is all about. I've removed the link again. --Mdwyer 16:10, 8 February 2007 (UTC)

Actually, "Notable and verifiable" isn't fully what external links are all about. In this case, the link contains information that is useful and interesting but not necessarily appropriate for inclusion in the article, in accordance with WP:EL.

However, the fact that the link employs a redirector URL to redirect to a domain on the Wikipedia blacklist seems like an attempt to circumvent the blacklist; therefore removal of the link is justified for that reason alone. -Amatulic 19:31, 9 February 2007 (UTC)

Agfa4000 was blocked as a sock puppet. I suppose there's another reason to remove the link. However, you both agree that the linked item was at the very least "Useful". Can any of the content of that article be used to expand the Wikipedia entry? --Mdwyer 19:48, 9 February 2007 (UTC)

The web site is far better than the pitiful paragraph that presently exists on the Wikipedia article. It is also better than anything elsewhere on the Internet. So it is very notable. It is also referenced. So it is verifiable as well. That is far more than can be said for the vast majority of links on Wikipedia, including most of those that appear on the completely unreferenced sites on this article. Why the site should be blacklisted is ridiculous. Hardly hard core pornography or Neo-Nazism is it ? No adverts either, so it can not even be considered as SPAM. Most of the Parkinson's Disease forums and web sites include variouspages form this web site. Wikipedia is just about the only Parkinson's Disease site that doesn't. The person that added it was a sock puppet doesn't prevent somebody else from adding it. If a banned member was the first to add a link to the Bible it certainly prevent anyone else from subsequently adding it. As for stealing some of it, there is a copyright notice on the web site, so you wouldn't be able to unless you wanted Wikipedia to be sued for it. Making useful information and links available to people should be the only issue. Instead I see reasons such as "notability" whatever that means, who added it rather than what was added, and whether or not it was a shortened URL. It seems some people don't care about giving the readers what they want. --DavidLeslie 21:34, 9 February 2007 (UTC)

Typically a domain will get blacklisted for persistent link spamming. That, plus POV-pushing, seems to be the case concerning viartis\.net (the destination site for the link in question) documented on Wikipedia:Long term abuse/General Tojo and the associated talk page. Blocked domains appear on meta:Spam blacklist, and any edit that includes a listed domain will get rejected. One can petition on meta:Talk:Spam blacklist to get the domain removed. However, as long as it's blacklisted, I don't think it should be circumvented with a redirect URL. I would suggest using the references cited on that page to improve the article here. -Amatulic 22:16, 9 February 2007 (UTC)

Let me clarify and amplify what Amatulic said -- I don't advocate "stealing some of it". You said that the site is well referenced. Those same references are also available to Wikipedia, and they should be cited and their information included. In reference to your comment about "making useful information and links available to people": Yes, Wikipedia wants to provide information to people. However, Wikipedia does NOT want to provide links for people. Wikipedia isn't a directory of links. If the information represented by this article is good information, and you seem to think it is, then it should be integrated into Wikipedia; not linked to it, and certainly not wholesale copied. In any case, this link wasn't necessarily removed because of WP:EL or WP:SPAM or WP:NOTABLE. When I removed the link it was because of the Spam section of WP:VAND. Mdwyer 22:43, 9 February 2007 (UTC)

None of the reasons given stand up to any scrutiny. Link spamming certainly doesn't because it uses a shortened URL. That doesn't link spam. Every single web site link spams ever time it is added anyway. What POV is the history of Parkinson's Disease pushing ! It doesn't push any POV. For a site to appear on a SPAM blacklist it is supposed to be SPAM, yet the site neither advertises nor sells anything. It simply isn't SPAM. Viartis is a medical research organisation based on one of the major Universities. It certainly isn't just an individual, such as a Wikipedia vandal. Either some Wikipedia Administrator has made a really false assumption or more probably some banned member has well and truly duped Wikipedia in to falsely assuming that the member is an entire organisation. Does the web page in question, which is far better than all of Wikipedia have been able to produce, really look like it was prepared by some Wikipedia vandal ? They must either be a complete imposter or at most a lowly employee. There are already over 60 references filling up the page, yet still the vast majority of information is not backed up by any references at all. Referencing everything will mean little but references.

Wikipedia does NOT want to provide links for people ! The Michael J.Fox web site is his own for his own issues yet that is on the Wikipedia web site as are thousands of other sites like it. The web site in question is for general use rather than an individual's benefit. It seems everyone thinks it is good information. It is certainly way beyond what exists on Wikipedia.

"Integrating" is copyright infringement. It isn't solely copying that is in breach of the Copyright Conventions. As for SPAM, what SPAM ? Let's play spot the advert. There aren't any. Try to buy something from the site. Yo can't. That's more than you can say for the other sites presently listed on the Wikipedia article. If you applied your reasoning to all other web sites, you'd have to remove virtually all of them.

As for WP:NOTABLE it doesn't look like you've read the article because it fulfills it far more than any of the other sites already listed.

--DavidLeslie 23:14, 9 February 2007 (UTC)

Works get copyright protection, not ideas. So, the information in this external site can be integrated, but the site cannot be copied. Otherwise, the owner of the external site would be guilty of violating the copyright of their dozens of sources. Mdwyer 23:21, 9 February 2007 (UTC)

You have a very naive view of copyright law. Even history books containing only facts and ideas can not have information readily lifted from them, even if they themself have taken infomation from elsewhere. The Berne Convention Article 10 limits what can be taken from an article regardless of whether it is only ideas or facts, and legally requires the naming of the source. This is why history books have to quote the history they take information from even if that history books is quoting other sources, because that book has made that information available to them.

I find it really odd and that a web site that is far better than what is in Wikipedia is banned without good reason, blatantly falsely claimed to be SPAM or not "notable" and yet then naive and illegal means are tried to find a way around the copyright so that as much of it can added anyway ! None of this matters. In a few months somebody would, without disussion, change anything that is written without anyone noticing.

Wikipedia looks pregressively more to me like a bad joke. Even a serious subject like Parkinson's Disease is subjected to continuous petty vandalism from what appears to be 6 years olds, or people with the intellect of six year olds. The editors lack any expertise yet write as if they do : not PD specialists, or even neurologists, but often computer engineers and the like. There are others who will revert just about anything, always managing to find some spurious reason to be negative. They are negative by nature. Other editors just want to feel they are being published because nobody in their right mind would publish them. People with PD are prolific exchangers of web sites. Yet I've never known anyone with PD quote the Wikipedia article, simply because it is so badly written. The six year olds, the amateurs and part timers, and the negetively minded should leave it to the professional experts, then maybe it would start to be a useful article rather than a haphazard compilation or inconsistent, false and inadequate information. --DavidLeslie 13:34, 10 February 2007 (UTC)

I've just noticed that you are a "computer scientist", that you were the one that reverted "questionable" improvements without being able to justify their questionability, and deleted the link in question. You are the worst kind of editor. You alter articles despite not having expertise in the subject. Unfortunately, there are far far too many people like you on Wikipedia. They ruin the entire principle on what Wikipedia is supposed to be based. Stick to what you know rather than interfere in subjects that you are not fit to deal with. Everyone will be better off. --DavidLeslie 14:07, 10 February 2007 (UTC)

I have to remind you of WP:NPA. You can attack my actions, but you may not attack me as a person. Ad hominem attacks do not make your case any stronger. In case you missed it before, I — personally — removed the link because it was vandalism. The correct way to make the Wikipedia article better is to add information directly to the article, and correctly cite the trusted and verifiable sources where that information came from. The use of an external link was incorrect in this case, and the editors — including myself — were justified in removing it for either WP:VAND or WP:EL.

The Berne Convention 10.1 says you can make limited quotations from a work. 10.3 says that you must credit the author and the source. This is what we do here at Wikipedia. We find the original source, quote from it, then give the correct citations to it. You seem to be misunderstanding something of this process. I'm sorry if I have been unable to make it clear. Perhaps reading WP:COPY will help you. --Mdwyer 17:48, 10 February 2007 (UTC)

I don't need irrelevant, endless and obvious misquotes of Wikipedia guidelines and copyright law. I haven't misunderstood anything. People shouldn't make spurious and ignorance based alterations to articles when they so very obviously don't know the subject ! --DavidLeslie 18:00, 10 February 2007 (UTC)

DavidLeslie, your personal attacks on and commentary about other editors is completely unacceptable. If you continue attacking other editors in this way, you will be blocked for disruption. Wikipedia is a collaborative project. If you are unable to collaborate respectfully with other editors, you are going to find your editing privileges are revoked. Sarah 18:05, 10 February 2007 (UTC)

I didn't mention any names when I wrote "People shouldn't make spurious and ignorance based alterations to articles when they so very obviously don't know the subject !" Are you claiming that people should make spurious and ignorance based alterations to articles when they so very obviously don't know the subject ?

Isn't describing somebody as unacceptable a personal attack. Why is it OK for you to criticise people's actions and not OK for others to criticise people's actions. Are there two sets of standards ? You need to look up the word "disruption". You're obviousy misusing the word in order to attempt to mirepresent the facts.

What editing privileges ? I don't see that there are any. How few seconds does it take anyone to register or reregister, or not even bother registering and just make changes anonymously anyway ?

--DavidLeslie 18:37, 10 February 2007 (UTC)

You are being disingenuous. You directed a number of personal attacks and personal comments at specific editors, even commenting on their careers and suggested they shouldn't be contributing to this article. This attitude demonstrates a fundamental failure to understand Wikipedia. Editing Wikipedia is a privilege, not a right. You don't seem to understand that. This privilege may be revoked if you are disruptive. Making personal attacks and editorialising about other editors is disruptive. As an administrator, I am trying to warn you that if you continue with these attacks and commentaries, I will block you for disruption. Sarah 18:52, 10 February 2007 (UTC)

You've tried to avoid answering all of the questions I asked. Is it because you don't like the answers ?--DavidLeslie 19:00, 10 February 2007 (UTC)

I've answered your questions.

If you continue attacking people and editorialising about them I will block you. This is your final warning. Thankyou, Sarah 03:33, 11 February 2007 (UTC)

What continuation ??? You're making it up. Provide timed and dated evidence. Why haven't you answered the questions I asked you. Where are your answers ??? You very obviously haven't answered them. I will challenge any blocking by you to more senior Administrators. They will undoubtedly reverse it because you do not have any evidence to support you. It would be a blatant abuse of your role as Administrator. Administrators who abuse their role can be removed, and that is what I would be demanding. --DavidLeslie 13:58, 11 February 2007 (UTC)

In case Sarah goes for the block, she has my full support. Your behavior is not appropriate here. If to you Wikipedia looks pregressively more [...] like a bad joke, you are free to leave the project anytime. -- Chris 73 | Talk 14:29, 11 February 2007 (UTC)

Calling me a liar (disingenuous is the same thing) is personal abuse. Justify your rudeness with evidence or apologise. Claiming that other people should not criticise and then being rude yourself is sheer hypocrisy. --DavidLeslie 14:11, 11 February 2007 (UTC)

If to you Wikipedia looks pregressively more [...] like a bad joke, you are free to leave the project anytime.

So are you claiming that it is not ridiculous that people make infantile additions such as "Poopoopoopoo" or "Johnny is gay" every other day to serious articles such as Parkinson's Disease ? Or that this article and others are written by people that have no expertise whatsoever or even knowledge in the subject. Or that virtually all this article consists of is revert revert revert, or lenghthy trivial disussions over one word or one web site, only for somebody to change it all just weeks later without anyone noticing. If somebody justifiably criticises it, all you write is go somewhere else. You're happy with it as it is are you ? Nobody in Parkinson's Disease has any regard for this article as it is. They largely ignore it. The rare mentions of it I have seen are mocking it. Are you proud and satisfied with that ? It shows that with some articles there is something seriously wrong. Your attitude of go somehwre else perpetuates that, as you are obviousy either satisfied with or ignorant of what goes on. --DavidLeslie 15:04, 11 February 2007 (UTC)

DavidLeslie (talk · contribs) is confirmed to be a sockpuppet of General Tojo (Wikipedia:Requests for checkuser/Case/DavidLeslie), and has been blocked indefinitely. -- Chris 73 | Talk 16:44, 11 February 2007 (UTC)

Tojo

It's Tojotime again. Low threshold for sprotect, please let me know if this continues. JFW | T@lk 07:47, 12 February 2007 (UTC)

blah blah blah - you're so deluded about your self importantance - you know nothing about Parkinson's Disease - you're only an ignorant GP ! not a PD specialist - not even a neurologist. It shows why this article is so badly written. Compare the poorly written, mistake ridden, indequate, and inconsistent Wikipedia article compiled by thousands of deluded amateurs to (link deleted) which was written by only one person that really does know the subject - supposedly Wikipedia's worst ever vandal ! Everybody on the Parkinson's Disease forums uses the web site I prepared. People rarely even mention the Wikipedia article, except to say how bad it is. It's hard evidence that with some subjects Wikipedia really doesn't work. General Tojo 11:20, 12 February 2007

Above posting by DrVoller (talk · contribs) & Daffy Duck II (talk · contribs) self-signing as indef blocked General Tojo - blocked indef. David Ruben ^Talk 13:18, 12 February 2007 (UTC)

Cheers David. His choice of pseudonyms is getting ever more esoteric. Oddly, Wikipedia remains #2 when searching Google.uk with "Parkinson's disease". JFW | T@lk 13:47, 12 February 2007 (UTC)

And thanks to Chris 73 for today's succesful Tojo hunt. It looks like he's got a new ISP or something. JFW | T@lk 21:54, 13 February 2007 (UTC)

I have responded in a bit more detail to your message on my talkpage.[3] Obviously, we will not yield to blackmail. JFW | T@lk 07:08, 14 February 2007 (UTC)

Sexuality and P.D.

I noticed this Joseph_M._McDade#Indecent_exposure and wondered if there might be a connection with his Parkinson's. - Kittybrewster 17:44, 19 February 2007 (UTC)

Why? Mushin^talk 02:30, 20 February 2007 (UTC)

Because of something I read in a PD magazine. Hypersexuality is a reported side effect of dopamine imbalance. - Kittybrewster 21:24, 24 February 2007 (UTC)

Potentially, but that is entirely speculative. --PaulWicks 09:49, 29 March 2007 (UTC)

My mother suffered from PD from her late 30's (when she was diagnosed) to her passing in her 60s. She had brain sergery in the early 1960s and while she seemed to regain some lost movement for a while after a year or so she was right back to where she started. She refused a second operation because it was too painful to go through that again. She then was one of the first to be put on dopamine -- that too worked for a short time but did not last. This article mentions seboria which I have but I don't recall her having. I am completely nonfunctioning sexually and a little stiff moving around. What is the percent of inherited PD? Does anyone know? I'm in my very early 60s.

Article should mention the genetic predisposition, but it's actually not very hereditable (5-10% at the most have a first-degree relative with PD). Seborrhoea is not pathognomonic, see below. JFW | T@lk 22:59, 16 April 2007 (UTC)

Seborrheic dermatitis

Seborrheic dermatitis is not due to dopaminergic deficit as is Parkinson's Disease. So there is no direct relationship between them. Although PMID 14678527 and PMID 12699724 suggest that Seborrheic dermatitis occurs in Parkinson's Disease, neither of them actually contain any original research concerning the subject. There is no research concerning Parkinson's Disease and Seborrheic dermatitis which shows that there is clearly a coincidence between them, just as would be expected given the distinct nature of the two medical disorders. --David Wittgenstein 19:59, 15 April 2007 (UTC)

Perhaps you should discuss things before removing them from the article. We are under no obligation to cite original research, but the Gupta paper seems to be a very up-to-date article on SD, and it is unambiguous. I have no data on the exact incidence of SD in PD. It may be unknown. The exact pathophysiology is probably also unknown. That doesn't detract from the fact that an observation has been made that has persisted for >100 years. Harrison's (16 ed) mentions it on page 2407. JFW | T@lk 22:59, 16 April 2007 (UTC)

The Gupta paper is recent but did not assess the incidence of SD in PD. Although it may clearly claim that SD coincides with PD it has no data with which to make that assertion. No research ever has. The exact pathophysiology of SD may not be precisely known but it certainly does not coincide with Parkinson's Disease by being a dopaminergic disorder.

SD is one of many medical disorders that are often claimed to coincide with Parkinson's Disease, and sometimes they do. However, they are not actual Parkinson's Disease symptoms or due to Parkinson's Disease itself because biologically they have nothing in common. --David Wittgenstein 23:20, 16 April 2007 (UTC)

Wikipedia is not an arbiter. If the literature is in error, we will cite in commission. The link has never been disproven.

I suspect you are using a pseudonym, given that PubMed only returns a cite (PMID 11693520) from your grand-uncle Ludwig.

Can you confirm you having nothing to do with a user known to us as General Tojo? JFW | T@lk 12:24, 17 April 2007 (UTC)

Scientific assertions have to be proven NOT disproven. If it were the other way around then editors could make thousands of spurious assertions that would have to remain in the article until you had proven them to be wrong. Anything that appears in any book or research paper could be added to the article. The assertion, when challenged, that a large proportion of people with Parkinson's Disease also have SD, could not be verified and so is in breach of Wikipedia guidelines. Discussions on the major Parkinson's Disease Forums, which involved thousands of people with Parkinson's Disease, make no mention anywhere of SD being a part of their symptoms. Grand Uncle Ludwig ??? General Tojo ??? --David Wittgenstein 13:08, 17 April 2007 (UTC)

When somebody has clearly run out of evidence and instead resorts to personal attacks, it usually means that reasoned and objective discussion has come to an end. I will therefore request Arbitration. --David Wittgenstein 13:43, 17 April 2007 (UTC)

The parkinson disease article has been disrupted for a long time by the banned User:General Tojo and sockpuppets (see Category:Wikipedia sockpuppets of General Tojo). New user accounts only editing this article, acting against discussion/consensus or from the very start displaying detained knowledge of wikipolicy to troll have often proved to be further sockpuppets of GT - of course not all such new user accounts and WP:AGF requires editors who watch this article against GT's actions to err on the side of caution and not bite a newcommer :-)

That said, it is not JFW who makes the claim of a link between the conditions, but it is to be found in the literature (PMID 14678527 and PMID 12699724). Wikipedia of course does not follow Scientific point of view as it is not its role to arbitrate what may or may not be correct (i.e. WP is not a soapbox even to correct real-world mistakes). To the claims that SD "has nothing to do with Parkinson's Disease": the two papers just linked from peer reviewed journals make such an observation and even of possible underlying mechanism of linkage. To assert that there is no link therefore would require citing from other reliable sources, rather than ones own disbelieve that there can be such a link (this would is excluded under WP:No original research).

JFW therefore makes valid points for including the information whilst accepting that it may or may not be "the truth" and it is not the place in WP or judge this. JFW is an experienced editor who gives clear pointers to policies - to take umbrage seems excessive. Claiming that JFW owns the article as you did at User talk:Bobzchemist, stating "has for a long time been preventing and reverting all but the most trivial amendments" seems a clearer breach of WP:AGF. David Ruben ^Talk 15:10, 17 April 2007 (UTC)

The two papers cited do not provide any evidence whatsoever that a large proportion of the people with Parkinson's Disease also have SD. They have made the claim without actually carrying out any research to see whether or not it is true. There is therefore no evidence at all to oppose. Merely making a scientific claim without any research to back it up is not scientific evidence. It is not up to an editor to disprove what has not yet in any respect been proven. If every unsubstantiated, unresearched and published claim concerning Parkinson's Disease can be inserted in to the article then there will have to be thousands of claims added to the article until they are disproven. --David Wittgenstein 15:45, 17 April 2007 (UTC)

Leave the link to seborrhoeic dermatitis in. If anybody has any information from (peer-reviewed) journals that says they are not linked, by all means put in a "this is disputed by others" with links to the articles. Remember to assume good faith and try not to escalate an amicable discussion into accusations about personal attacks.Mmoneypenny 16:31, 17 April 2007 (UTC)

There is no evidence to show that Seborrheic dermatitis is a symptom of Parkinson's Disease and there never will be because they are completely different medical disorders that are biologically completely distinct. So are you claiming that if anyone makes any medical claim that has no scientific basis or scientific data in support of it that it should remain with "a disputed by others" sign attached to it. If so, there are a few thousand spurious claims that can added to the Parkinson's Disease article that are equally without a shred of evidence in support of them. Shall I start adding them ? --David Wittgenstein 17:20, 17 April 2007 (UTC)

It is being claimed here that Seborrheic dermatitis is a symptom of Parkinson's Disease. Yet on the world's largest Parkinson's Disease Forums : Neurotalk, Braintalk, WeMove, HealingWell, National Parkinson Foundation, there is not even one person that claims Seborrheic dermatitis as one of their symptoms. The claim that Seborrheic dermatitis is a symptom of Parkinson's Disease is not only completely unproven and scientifically baseless, but it bears no resemblance to reality. --David Wittgenstein 17:25, 17 April 2007 (UTC)

David, I would suggest that you allow Bobzchemist to have a look at this, as you requested he do. I would also counsel that you explore the rest of wikipedia as I'm sure you will be able to help out on other articles. I am concerned that you state so absolutely that SD and PD are "completely different medical disorders that are biologically completely distinct" because this may not be the case and you are claiming knowledge which is not available to you. I do not mean to offend in any way and I would ask others to get in touch with me if this is seen as an ad hominem attack, which it is not meant to be. All the best.Mmoneypenny 18:21, 17 April 2007 (UTC)

PD and SD are very obviously "completely different medical disorders that are biologically completely distinct". Do you have any reason to believe that they aren't ? If they aren't, why do they have completely separate articles on Wikipedia, with the SD article not even mentioning Parkinson's Disease ? --David Wittgenstein 18:33, 17 April 2007 (UTC)

I have cited extensive medical sources documenting a link. It is regarded as an autonomic phenomenon. What evidence can you provide that disproves the link? JFW | T@lk 18:37, 17 April 2007 (UTC)

You are going around in circles ignoring what has been previously written. That is why arbitration is clearly needed. You have cited medical sources. However, those medical sources do not contain any research data whatsoever concerning the issue. The citation authors did not carry out any research concerning the question. A mere claim without evidence to support it is not scientific evidence. If it were, then any claim that were made would be assumed to fact. It is up to the editors that want to include supposed facts to provide the evidence. It is not up to others to disprove them. Go to the web sites of the Parkinson's Disease Forums I listed. You will not find any mention of any of those many thousands of people with Parkinson's Disease also having Seborrheic dermatitis. Very odd for something that you are claiming is a Parkinson's Disease symptom. --David Wittgenstein 18:49, 17 April 2007 (UTC)

Okay, last comment from me, for fear of feeding the trolls and/or biting newcomers. Another article (PMID 11934340) which specifically quotes seborrhoea as one of the non-motor symptoms of Parkinson's. David, how likely is it that these separate researchers are all fabricating seborrhoea as a symptom of Parkinson's? If you can really prove otherwise, perhaps you could write to the journals involved and have them print a retraction? I also appreciate that the SD article does not mention PD but: a) it isn't much more than a stub and b) the two external links from the SD page do mention a link between PD and SD. Lastly, I hope just because your first few edits here have met with resistance that you will not be put off helping wikipedia become a better place. All the best.Mmoneypenny 20:03, 17 April 2007 (UTC)

David's argument is that we have not provided the source that makes the original claim that SD is associated with PD. I have looked for this, because I always aim to cite original source material for historical interest. In this case, I went back as far as I could, but it seems this phenomenon was first recognised in the late 1800's, and PubMed doesn't go back that far (or any available online resource). But - as Mmoneypenny states - we don't need the original evidence. All we need is support that this phenomenon is recognised in clinical medicine, and this I have provided.

As I stated, David, websites of patients are not generally suitable to prove or disprove clinical associations. After all, seborrhoeic dermatitis can be mild and the patient may never has sought help for it.

If David is not associated with General Tojo then I apologise for even suggesting that he may have been. But I never actually did that. All I wanted was a reassurance that this new editor with strong views on PD will not cause the same degree of trouble as Tojo did in his time. I don't think that's unreasonable. JFW | T@lk 20:21, 17 April 2007 (UTC)

Published medical research must be assessed regarding its (1) methods, (2)results, and (3) conclusions. A great deal of medical research is irrelevant because either its methods are bad, its results are low in significance, or because its conclusions do not match the results. Despite this, flawed or insignificant research still gets frequently quoted. You have provided details of published research. However, there were no methods, there were no results, there were only conclusions. The conclusions have not been based on any actual research. They are merely repeating a traditional notion. That is not scientific evidence. Claims going back over a hundred years does not mean that they are true. Such longstanding claims are often found when assessed to be false.

There is plenty of evidence of virtually all of the other symptoms occurring in Parkinson's Disease, and that they are a result of it. However, for seborrhoeic dermatitis there is not a shred of published research data showing that it is a Parkinson's Disease symptom. In surveys of symptoms of Parkinson's Disease that people actually experience, seborrhoeic dermatitis never comes up as one of them. Also, although there are some uncertainties over its causes, it is not in doubt that Seborrhoeic dermatitis and Parkinson's Disease are biologically distinct.

Dementia is not a Parkinson's Disease symptom, but there is plenty of evidence that dementia frequently occurs alongside Parkinson's Disease, and that it often develops alongside it. There are many other disorders that can occur simultaneously with Parkinson's Disease, such as hypothyroidism, diabetes, migraine. Seborrhoeic dermatitis may be one of them. However, the frequency of their simultaneous occurence is not great enough to justify their inclusion alongside Parkinson's Disease symptoms as dementia is.

--David Wittgenstein 21:17, 17 April 2007 (UTC)

I have given my argument often enough: you may disagree with (or fail to understand) a notion that is widely held in the medical field, but that does not invalidate it. Of course it would be desirable to know how strong the association between SD and PD actually is. But it is repeated time & time again in the literature, without any obvious attempts to disprove it. Wikipedia is fully within its own editorial policies to cite the association, as it is well known and not really disputed (apart from by you). Please check WP:NOR. Andrew73 (talk · contribs) has kindly inserted the Gupta reference into the article. In your view, which Wikipedia policy is still breeched by mentioning SD as being associated with PD? JFW | T@lk 23:16, 17 April 2007 (UTC)

Your arguments don't stand up to any scrutiny. There is nothing to misunderstand. On Wikipedia, facts must be verifiable, yet (1) SD has never been shown to be a symptom of Parkinson's Disease, (2) has never come up in surveys of Parkinson's Disease symptoms, (3) is never reported as a symptom on any of the world's largest Parkinson's Disease Forums, (4) has no common biology with Parkinson's Disease, (5) has no possible biological means of being explained as a Parkinson's Disease symptom, (6) is considered by Wikipedia as a completely distinct medical disorder rather than a Parkinson's Disease symptom. There is a complete lack of evidence in support of any claim that SD is a Parkinson's Disease symptom. There is nothing to oppose or contradict. All we have so far is notions in the medical literature. Notions are not scientific evidence, no matter how many people have them. If the standards for inclusion are so low that any scientifically unsound and unproven notions that appear in the medical literature are considered reasonable for inclusion then there are thousands of them. Shall I start adding them all ? Or are there double standards here ? --David Wittgenstein 06:29, 18 April 2007 (UTC)

How do you define symptom? I don't think the article is arguing that seb. derm. is a cardinal feature of Parkinson's disease nor is it arguing that seb. derm. is a presenting symptom of PD. I agree that this association shouldn't be overstated, but at the same time, I don't think the article is doing this. Nevertheless, associations are worth mentioning in an article, even if they don't overtly fit with the pathogenesis of PD. Andrew73 11:27, 18 April 2007 (UTC)

A symptom is the result of the biochemical or physical fault of that medical disorder. For example, high blood glucose level is a symptom of diabetes as a result of insulin deficiency because insulin normally lowers blood glucose level. Seborrheic dermatitis could not be a symptom of Parkinson's Disease because it is, unlike Parkinson's Disease, not due to a dopaminergic deficit. Seborrheic dermatitis is a separate medical disorder.

There is no data at all showing that seborrheic dermatitis, even as a separate medical disorder, does coincide with Parkinson's Disease any more that many other medical disorders. In fact, when surveys of Parkinson's Disease symptoms have been made, seborrheic dermatitis doesn't come up as one of them. --David Wittgenstein 11:45, 18 April 2007 (UTC)

Okay, "symptoms" are what patients report, so if you wanted to be strict about this, I don't think high blood glucose levels are a "symptom" per se of diabetes, but a finding or sign of diabetes. So I agree, patients with PD may not necessarily complain of seborrheic dermatitis (and hence do not report it in the surveys or forums that you have mentioend) when there are other more dominant findings (e.g. the motor findings). However, from what I can see in PubMed, this association, appears to exist, though perhaps not at rigor of criteria that you desire. Andrew73 12:41, 18 April 2007 (UTC)

What exists in the medical literature are only claims that it is a Parkinson's Disease symptom or that it frequently coincides with Parkinson's Disease. There is no proven association, no criteria has been met, no survey results, no prevalence data - nothing at all. Unfortunately, the medical literature consists of a huge number of claims that have no actual evidence to support them. If claims were made in the medical literature of a drug being able to treat Parkinson's Disease, that assertion certainly wouldn't be added to the article if there was no clinical data to back it up. --David Wittgenstein 13:29, 18 April 2007 (UTC)

The bar for claims of drug efficacy is certainly higher than making a rather modest claim linking seborrheic dermatitis and PD. The Gupta review article mentions several findings: PD patients may have increased sebum levels; there are higher levels of alpha-MSH in patients with PD, L-DOPA appears to reduce sebum secretion, etc. However, the findings aren't completely consistent, and many of the studies referenced are quite old and probably have few patients. Again, I don't think a one line mention in the wikipedia entry is beyond the pale of acceptability. Andrew73 14:18, 18 April 2007 (UTC)

Those symptoms are not even proof of seborrheic dermatitis, and the oiliness of the skin has already been included separately in the article. If not only a lack of evidence, but claims that do not match the evidence are sufficient for inclusion in the symptoms section then there are a large number of other medical disorders that should be included in the symptoms section because there is far more evidence of them coinciding with Parkinson's Disease - hypothyroidism, migraine, diabetes, the common cold, and many more ! Just like seborrheic dermatitis, these aren't symptoms of Parkinson's Disease either. --David Wittgenstein 15:01, 18 April 2007 (UTC)

Have you made an attempt to read the article that has been cited. The Gupta paper is really quite comprehensive in its examination of the perceived link between PD and SD.

To deal with the point you have made repeatedly (that there is no plausible link) - this is a phenomenon that affects all of medicine. Cancer patients may suffer drenching night sweats, yet their tumours do not produce hormones that act on sweat glands. A solid explanation is lacking. Patients with vitamin B12 deficiency may have temperatures, even in the absence of neutropaenia or infection; nobody knows why. I can list many "significant" symptoms and associated conditions that have not been elucidated. But did James Parkinson know about dopamine? Would you have stopped James Parkinson from describing the hypokinetic-rigid syndrome simply because an explanation was lacking? It seems you are demanding the impossible. JFW | T@lk 16:14, 18 April 2007 (UTC)

People with Parkinson's Disease simply do not get seborrheic dermatitis as a result of having Parkinson's Disease. At the time of James Parkinson he had few patients to choose from. He had to make do with what was available. However, nowadays there are millions of people known to have Parkinson's Disease. It is very apparent that most of them plainly do not have also have seborrheic dermatitis. If the standards are so low : no prevalence data, no biological basis, then that standard should apply to all symptoms and medical disorders. So are all of the many medical disorders and symptoms with such tenuous and unproven links to Parkinson's Disease now going to be added to the article, because if they are the entire section will be full of them ? --David Wittgenstein 17:14, 18 April 2007 (UTC)

So you regard testimonials by individual patients on website noticeboards as more reliable than the collective experiences of neurologists experienced in treating Parkinson's disease? Anyway, you have already given yourself away. I'm finished going round in circles. You have not provided a shred of negative evidence, apart from of course your firmly held opinion. JFW | T@lk 21:37, 18 April 2007 (UTC)

Prevalence studies are what is needed, showing that seborrheic dermatitis commonly occurs simultaneously with Parkinson's Disease. These exist for the actual Parkinson's Disease symptoms. They exist for medical disorders such as dystonia and dementia, which are not Parkinson's Disease, but which commonly occur simultaneously with Parkinson's Disease. No such data has ever existed for seborrheic dermatitis. That is plainly negative evidence, as is the complete lack of scientific rationale that would explain why seborrheic dermatitis would commonly occur simultaneously with Parkinson's Disease. Increased sebum secretion alone is not seborrheic dermatitis.

My question keeps on going unanswered : Are all of the many medical disorders and symptoms with such tenuous and unproven links to Parkinson's Disease now going to be added to the article ? --David Wittgenstein 11:09, 19 April 2007 (UTC)

As the discussion has not resulted in "consensus", and appears to have come to an end, rather than request a third opinion, which is now no longer appropriate, I will request full arbitration. --David Wittgenstein 18:26, 19 April 2007 (UTC)

You don't seem to understand what "arbitration" means. Arbitration is for policy violations. We are having a content dispute, on which the arbitration committee will not rule.

You rightly tried to find a mediator, in the person of Bozchemist. He has not responded.

You asked whether conditions with tenuous/unproven links are now going to be added. It depends a lot. You show the "tenuous" links and other contributors will respond whether their inclusion is suitable. Without high-quality references, this will be difficult. You have already been shown the fairly good references available linking SD to PD. If you can provide similarly high-quality references, it will not be difficult do decide on inclusion. JFW | T@lk 09:42, 20 April 2007 (UTC)

The Return of Tojo

David Wittgenstein was, of course, a Tojo sock - as confirmed by CheckUser. I have blocked that account. Given that he usually responds by unleashing hordes of sockpuppets, I have fully protected the article. It remains a shame that the normal editing process is interrupted repeatedly by a single individual. JFW | T@lk 10:48, 20 April 2007 (UTC)