'Above and Beyond'
Personalized approach to Parkinson's treatment
March 17, 2025
4 minute read
Personalized approach to Parkinson's treatment
Weird sensations. A foot that dragged. Rob Seidl, 47, was in his late 30s when he noticed these unusual symptoms. He figured his work as an aircraft mechanic in Green Bay was taking a toll on him. But his primary care doctor was concerned enough to send him to a local neurologist who gave him a tentative diagnosis of Parkinson’s disease, a progressive neurological disorder characterized by symptoms like movement problems, behavioral health issues and other health concerns.
The neurologist prescribed carbidopa/levodopa, a combination medication that prompts the brain to produce more dopamine. This medication can wear off during the day, even when it is taken on a meticulous schedule. Its effectiveness can also diminish over time. When the medication no longer worked for Rob, he sought new medical expertise.
“The diagnosis doesn’t come with a book that says, ‘Welcome to Parkinson’s — Here’s What You Need to Know,’” Rob said. “You’re on your own. I dove into learning as much as I could.”
This proactive approach led Rob, of Greenleaf, to experts at the Froedtert & the Medical College of Wisconsin Neuroscience Center who diagnosed him with young onset Parkinson’s disease. The disease affects people younger than 50.
“Most traditional Parkinson’s disease diagnoses occur between the ages of 60 and 65,” said Ryan Brennan, DO, neurologist and MCW faculty member. Dr. Brennan, who practices as part of the Wisconsin Institute of NeuroScience (WINS), oversees Rob’s care.
Parkinson’s disease is related to a degeneration in the substantia nigra, an area of the brain that controls dopamine production. Because dopamine acts as a chemical messenger for movement and other body functions, its absence can lead to Parkinson’s disease symptoms like slow movement, stiff muscles, balance issues and tremors.
“As people lose those brain cells, they lose dopamine, which can affect multiple aspects of their health,” Dr. Brennan said.
To confirm the Parkinson’s disease diagnosis, Dr. Brennan ordered a DaT (dopamine transporter) scan, which provides insight into the dopamine system of the brain. It is a puzzle piece that allowed the medical team to better understand and manage Rob’s condition.
Dr. Brennan encouraged Rob to try an alternate treatment delivery method for carbidopa/levodopa, using a pump to continuously deliver a gel form of the medication through a tube surgically implanted into the intestine. The Froedtert & MCW health network is one of a few systems in Wisconsin to offer this treatment option.
“When it works well, it works very well,” Dr. Brennan said. But in Rob’s case, his active lifestyle caused a few problems, and he kept accidentally pulling out the tube. He decided to discontinue using the pump.
“Every patient is different, so an individualized treatment plan is important,” Dr. Brennan said. “Dosages and delivery methods need to be patient specific and often need adjustment over time.”
Fortunately, Rob still had treatment options. Dr. Brennan prescribed a newer extended-release form of carbidopa/levodopa that offers steadier treatment and better symptom control throughout the day. It was the approach Rob needed.
“It has been awesome for me,” Rob said. The extended-release medication can be a welcome improvement from immediate-release medication that provides a quick burst of relief, but then not enough relief until the next dose.
Rob also did genetic testing, which determined that he has a PRKN gene mutation, which can lead to Parkinson’s disease. This gave Dr. Brennan another puzzle piece to unlock the best treatment regimen.
“In terms of prognosis, this genetic mutation is not a worse prognosis,” Dr. Brennan said. “It just means he was genetically predisposed to develop the disease early on.”
For now, a cure for Parkinson’s disease remains elusive. Ongoing research and treatment options aim to slow the disease’s progression. Deep brain stimulation, a surgical procedure, can alleviate symptoms in some patients. For people with Parkinson’s disease, the Froedtert & MCW Neuroscience Center, a designated Parkinson’s Foundation Comprehensive Care Center, offers the latest options.
“I’d follow my care team to the moon if they left,” Rob said. “Dr. Brennan goes above and beyond. I’ve had Parkinson’s for 10 years, and I am still able to do the things I enjoy. This isn’t tooting my own horn. This is testimony to the care I’m receiving.”
