Ask the Neurologist: A Discussion with Dr. Martin Wagner

A few weeks ago, I had the pleasure of interviewing my neurologist of four years, Dr. Martin Wagner. Dr. Wagner earned his undergraduate degree from Baylor University in Houston, with honors. He then attended University of Texas at Houston and earned his doctorate degree, again with honors. Each week, I will submit portions of our conversation exclusively for Parkinson’s hopeDIGEST readers. I want to thank those readers who e-mailed their questions to me and I promise, your questions have been answered, so stay tuned to this special series!

This series is intended to open discussions about different Parkinson’s disease treatments. As always, please consult your own neurologist before making any changes to your treatments.

Q.  Tell me how you got interested in Neurology.

Dr. Wagner:  I became interested in neurology because I did well in the class! I completed a full residency in neurology and full residency in psychology. While some med students are faced with deciding what field to specialize in, my specialization became quite clear. I achieved honors in the neurology classes and it came very easy to me. On a personal note, my mother suffered a stroke when she was 55 years old. She couldn’t express herself and that lasted for several days. I was a medical student at that time and aphasia (the inability to use or comprehend words) wasn’t known to me. I was naturally interested in learning more to understand my mother’s ailment. Some years later, my father-in-law began suffering some symptoms and his doctors couldn’t diagnose it. I knew immediately it was Parkinson’s disease from just observing him. My first wife passed away with tongue cancer and I eventually married my present wife. Again, her father had symptoms that left his doctors perplexed.  I had the unpleasant duty of diagnosing him with ALS or more commonly known, “Lou Gehrig’s disease”.

Q. How long have you been practicing?

Dr. Wagner: 24 years

Q.  Why is the Parkinson’s disease tremor the least responsive to dopamine? Is it because the dosage should be increased from the present one?

Dr. Wagner:  It is simply the least responsive to dopamine therapy. It’s not that the dose isn’t sufficient. It’s a different mechanism. The death of neurons results in deficiency which causes stiffness, postural instability, and so on.  Tremor may be attributed to acetylcholine and dopamine. Benadryl can help in reducing the tremor. Side effects can include constipation, dry mouth, etc.