Graham A. Glass, MD

Caring.com Expert

About

Graham A. Glass, MD, is the deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center (PADRECC) and an assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

The bulk of his research is clinical in nature, and his topics of publication include the management of Parkinson's disease, gait disorders, dystonia, myoclonus, and multiple system atrophy. Glass is active in the education of students, residents, fellows, and other physicians. He sees patients at UCSF Medical Center; the V.A.; and in Anchorage, Alaska, where he is a visiting clinician four times per year.

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Recently Published on Caring.com

  1. Wednesday November 16, 2011

    1. Is taking Prednisone and Neurontin a problem for my mother who has Parkinsons?

      Answer - Typically Prednisone nor Neurontin are a problem in and of themselves for Parkinson's disease patients. They don't really interact with the PD meds (though I obviously don't know your mother's specific regimen). That being said, they do have independent side effects and affect all patients in different ways...

  2. Monday October 31, 2011

    1. What kind of specialist should I go to about my husband's confusion and movement disorder?

      Answer - This is a difficult situation as "vascluar parkinsonism", "vascular dementia" and other "structural causes of Parkinsonism" are very difficult to treat. My sense is that a very thoughtful memory expert (sometimes called a behavioral neurologist) may be helpful in some regards and may help with confusion...

    2. Are my husband's new addictive behaviors related to his Parkinson's medication?

      Answer - Addictive and compulsive behaviors have been linked to some Parkinson's disease medications and we often reduce medications or alter medication regimens when we hear of this type of behavior. The "bad actors" in this regard are the dopamine agonists such as ropinirole and pramipexole (Requip and Mirapex)...

    3. Is it the caffeine in coffee that helps prevent Parkinson's?

      Answer - The Parkinson's Disease research community isn't really sure about the answer to the question as to the reason for why coffee drinkers are less likely to develop Parkinson's disease, although similar reductions in risk have not yet been noted in other caffeinated beverages...

  3. Friday July 29, 2011

    1. Can Parkinson's cause petit mal seizures?

      Answer - The short answer to your question is "no." On occasion we have patients with PD, particularly those with a lot of cognitive symptoms have episodes that look like partial seizures such that they are staring off or somewhat unresponsive for a few moments...

  4. Wednesday July 20, 2011

    1. How can we keep my father, who suffers with Parkinson's, awake during the day?

      Answer - I'm sorry to hear that father is only awake for what sounds like a few hours a day. I agree with many of the other answers, as sleep disorders are part and parcel of PD. That being said, there are a number of step that we take to try and help:

    2. What are good books to read about Parkinson's dementia caregiving?

      Answer - This is a good question, and I'm not sure that I have great answers for you. In terms of dealing with the dementia issues, books like "The 36 hour day" have been helpful for some of our patients even though it is targeted more at Alzheimer's disease. The basic principles hold true.

    3. With all the problems Dad has been having lately, could he be suffering from Parkinson's disease?

      Answer - I'm sorry to hear that things have been getting pretty rough for your father. This is a very difficult situation and based on the symptoms and signs that you describe there are a number of possibilities. My sense is that visiting a "behavioral neurologist" who specializes in memory loss issues or a movement disorders specialist would help...

  5. Tuesday July 12, 2011

    1. Is my mom's Parkinson's medications causing her to yell out loud?

      Answer - I am writing in reply to the comment posted by GLMMOLIVER regarding the use of quetiapine and clozapine in PD. This brings up an important issue regarding "evidence based medicine" and how it can effectively be applied to actually taking care of patients...

  6. Monday June 27, 2011

    1. How to help with falling issues of a Parkinson's Disease patient?

      Answer - Falling is a very difficult problem in Parkinson's disease, as a patients' sense of balance is not helped by any of the medications that we use to treat PD. If the patient is falling because their legs freeze up and then they fall forward, we will often be able to help by increasing the medication dose...

    2. How can I best care for my father with Parkinson's disease?

      Answer - This is a very tricky problem and we often encounter this when patients have had PD for many years and/or with our older patients. We often struggle to strike a balance between treating the "motor symptoms" like the tremor and stiffness and causing side effects from the medication...

    3. Am I experiencing symptoms of Parkinson's disease?

      Answer - The genetics of Parkinson's disease are not as well understood as we would like. Although you may be at a slightly higher risk of developing PD, as far as we know, fewer than 7-8 percent of cases of parkinson's disease are "monogenetic". Although I would refer you to a neurologist or a movement disorders...

    4. Do you have any info about Parkinson's wellness program?

      Answer - This is an interesting question, as occupational therapists can be incredibly helpful in helping PD patients manage their deficits. Although I do not, there are a number of wellness centers in various regions of the country that may. I'm sorry to not have a great answer to your question

  7. Thursday May 26, 2011

    1. Are there any better medications for Parkinson's than Carbidopa and Levodopa?

      Answer - Carbidopa/Levodopa, though around since the early 70's in a usable form, still remains the gold standard for Parkinson's patients. Although there are a number of other medications including the dopamine agonists (ropinirole, pramipexole), MAO-inhibitors (rasagiline, selegiline), COMT inhibitors (entacapone...

  8. Monday May 23, 2011

    1. How do I get my wife with Parkinson's disease to take her medication?

      Answer - This sounds like a very difficult situation in which the Parkinson's and stroke are interacting. I would reccomend that you meet with a speech pathologist who can check to see if her ability to swallow is still fully intact. If so, this represents a very difficult situation in which one may need to...

    2. Are blood pressure spikes a common side effect of adjusting Parkinson's medication?

      Answer - Parkinson's disease often affects the autonomic nervous system ("internal nervous system") which is responsible for why patients with Parkinson's disease often have constipation, bladder urgency, and can have low and/or swinging blood pressure.

  9. Wednesday April 06, 2011

    1. What can we expect at this stage of Parkinson's disease?

      Answer - Although we "stage" Parkinson's disease for research studies, this often doesn't help predict how patients will progress and what type of assistance/living situation they will need. From your description, it sounds like she is at a later stage of disease and may have some cognitive involvement as well...

    2. Are my mother's sleep problems connected to her Parkinson's?

      Answer - Yes, this can be related to her Parkinson's disease, as patients with PD can have a number of sleep problems including acting out dreams at night, difficult with sleep maintenance (fall asleep okay but then only sleep for an hour or two), restless legs, and potentially a higher risk of sleep apnea...

    3. Am I at risk for Parkinson's?

      Answer - This is a very difficult question to answer and to some degree depends on the age at which your father was disgnosed (young onset is more likely to be monogenetic) and whether or not he has a known genetic mutation or risk factor. Typically, however, we think that less than 8% of all parkinson's patients...

    4. What is the difference between mild cognitive impairment and Parkinson's dementia?

      Answer - Mild cognitive impairment implies that a patient is not normal in one or more "domains" of memory, but is not severly struggling in these areas to a degree that it impacts day to day function badly. PD with dementia is thought to be more severe and often patients with PDD (Parkinsons Disease with Dementia...

  10. Tuesday March 29, 2011

    1. Is it normal to talk in your sleep while on Carbidopa?

      Answer - More than half of patients with Parkinson's disease will at some point have what we call "REM sleep behavior disorder" or RBD. This means that they act out or vocalize their dreams. Behaviors range from simple conversations to kicking, punching and even falling out of bed...

  11. Tuesday February 01, 2011

    1. Is the Theracycle beneficial to those with Parkinson's?

      Answer - As you and your mom know, exercise is very important in Parkinson's disease and more and more studies have shown the benefit of various types of exercise in Parkinson's disease. Studies have shown great benefit to tandem bicycle riding, tango, and other forms of vigorous exercise...

  12. Tuesday January 25, 2011

    1. How can I get my father to accept his Parkinson's diagnosis?

      Answer - Accepting the diagnosis of Parkinson's disease and the physical limitations that may result is occasionally very problematic for patients. As you well know, this often results in a fair amount of turmoil for the family and can result in injury or overall reduced quality of life for the patient...

    2. What disorders mimic Parkinson's disease?

      Answer - There are a number of disorders that share some of the same symptoms as Parkinson's disease and can result in "diagnostic confusion" for physicians and patients alike. Often, when patients are progressing very rapidly, develop balance problems within the first few years, don't respond to a strong dose...

  13. Friday January 14, 2011

    1. Could Dad's Parkinson's medication adjustment be causing his seeming mental decline?

      Answer - This is a very difficult situation that your father is facing, as Parkinson's patients very often decline for a while when hospitalized. I would expect that the long hospitalization with pneumonia contributed to his confusion. Although sinemet can cause confusion, hallucinations and other side effects...