My FIL's has Parkinson's disease and lost balance and speech control. Kindly help.

Question

Hello doctor,

My father in law is suffering from Parkinson's disease for the past year. We continue taking treatments, but the condition worsens day by day. Now he completely lost his balance, cannot walk alone, cannot do daily work and require assistance, cannot control urinating in the night, and speech is very unclear. I had all reports and prescriptions for the last one year. Kindly suggest what to do.

Answer 1

Hello,

Welcome to icliniq.com.

Sorry to hear your FIL‘s symptoms. I read all the reports and the MRI report and the prescription which the doctor wrote (attachment removed to protect patient identity).

Considering all the number of falls that he had in a year, it does not seem to be a typical case of Parkinson's disease. This seems to be more than Parkinson’s disease. There is a group of condition called Parkinson plus disease in which there can be falls, vision problems, difficulty in looking downward direction, and one of these is called PSP (progressive supranuclear palsy). In PSP, the progression of symptoms is fast, like in one year or one and a half years, and very high doses of Syndopa (Levodopa and Carbidopa) needs to be given. The usual dose is 125 mg twice daily or three times daily in a normal Parkinson's disease, but it has been prescribed 250 mg thrice daily. Even that also is not effective in controlling symptoms of your father-in-law.

One more way of confirming PSP is getting an MRI brain done with PSP protocol and confirming midbrain atrophy on the MRI (magnetic resonance imaging), which the radiologist will do. I will also be able to better interpret your FIL's findings better through a video consult if you book one.

For now, I can advise you to continue Syndopa tablet as prescribed. Meanwhile, if you can book an MRI brain with PSP protocol, it will be very good.