Health & Nutrition - - Q&A - Dr. P. P. Ashok, Con­sul­tant Neu­rol­o­gist, an­swers

My hus­band was di­ag­nosed with Parkin­son’s Dis­ease about 8 to 9 years ago. In the be­gin­ning he could do all his chores (bathing, etc.) on his own. But now he needs con­stant help and lately he has suf­fered re­peated falls while get­ting up from a chair, while turn­ing, bend­ing. My ques­tions: Are th­ese falls due to the dis­ease it­self or due to side ef­fects of the med­i­ca­tion? His dosage was ad­justed but even that has not helped much. The neu­rol­o­gist is now of the view that my hus­band is ac­tu­ally suf­fer­ing from a con­di­tion called Pro­gres­sive Supranu­clear Palsy. Is this an ad­vanced stage of Parkin­son dis­ease? Almost all his falls have caused head wounds, esp on the skull cap and the brow. Could the cu­mu­l­u­la­tive ef­fect of th­ese falls re­sult in any other type of brain prob­lems? His speech has be­come so muf­fled and in­dis­tinc­tive that even when I’m sit­ting right next to him, it’s dif­fi­cult to hear or un­der­stand him. Please clar­ify and also pro­vide a so­lu­tion for his falls.

PReena Sharma, Mumbai

arkin­son’s dis­ease af­fects the mo­tor func­tions. As the dis­ease pro­gresses many pa­tients tend to lose pos­tural bal­ance to a size­able de­gree. There is how­ever a va­ri­ety of the same group of dis­eases called Parkin­son plus syn­drome or PSP (Pro­gres­sive Supranu­clear Palsy) where falls are a prom­i­nent fea­ture. Un­for­tu­nately this sub­group gen­er­ally doesn’t re­spond to drugs. The only so­lu­tion for man­ag­ing th­ese pa­tients is to pro­vide ad­e­quate at­ten­tion and care so that the falls are limited. At­tend­ing a Parkin­son’s Support Group meet­ing would be a good idea to start with. There you’ll learn more about the kind of care your hus­band needs, like phys­i­cal ther­apy, speech ther­apy, etc. Some pa­tients with Parkin­son’s dis­ease do go on to de­velop de­men­tia, and this is not in any way re­lated to the falls they ex­pe­ri­ence. The dis­ease it­self can bring about changes in the brain that af­fect men­tal func­tions. So apart from poor mo­tor func­tion, the pa­tient may ex­pe­ri­ence mem­ory loss, hal­lu­ci­na­tions and so on.

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