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Re: LBD and MSA

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April, I looked up MSA on Google.com, using medical disease MSA, and it had

quite a bit to say about MSA.

My husband didn't do well at all on the numbers of counting backwards by 7,

and you may not know that he had worked with figures on a daily basis in an

office, doing estimating on big multimillion dollar jobs. That was before the

days of computers doing it for them. He was great with any complicated math.

Yet, my poor man couldn't do the count backwards by seven thing at all. He

failed several of the test.

April, I hope things go well for your FIL, and the he doesn't have something

that can't be helped. Which is anything we talk about on this List, I guess.

Oh mercy!

Imogene

Caregiver for my True Texas Gentleman husband of 35 years. He has AD and

possibly LBD, is Taking Aricept.

In a message dated 4/25/2006 2:14:36 PM Central Daylight Time,

aswest1021@... writes:

Hello Everyone,

I just got home from the appointment my FIL had today with a

neurologist at Emory for a second opinion. He put my FIL through a

battery of tests to watch how he tracks his eyes from L to R and up

and down. He did fairly well with that. He also had him subtract a

series of numbers by 7 each time and he did well with that, too.

The shocker came when my FIL was asked what month it was and he said

May. He, then, was asked what year it was and he said it was 1974.

I was completely stunned. He also didn't know the day of the week,

but could tell the city and state he was in. He tested my FIL's

mobility by having him walk with and without his walker.

Surprisinly enough, he did relatively well. Of course, not long

after we left the doctor's office, he got really bad. We went to a

restaurant and three different men had to help him get seated and

stand back up again. When we got back to my house, he fell

backwards and fell into the garbage can, but didn't get hurt,

thankfully.

Anyhow, due to my FIL's memory problems and the fact that he has an

active tremor, the doctor said he doesn't have " typical PD " . In

fact, at this juncture, he's leaning towards Diffuse Lewy Body or

Multiple Systems Atrophy (because he's having problems with urinary

incontinence and constipation). So, he's ordered that my FIL

undergo 4 hours of neuropsychological testing in 6 weeks and he's

also ordered an MRI. He said those things should help him come to a

definitive diagnosis. He's going to wean my FIL off the Sinemet CR

during the day over a period of the next three weeks. He said his

philosophy with meds sometimes is that less is more. Does anyone

here know anything about MSA? What is the prognosis, in comparison

to LBD? Any info. would be much appreciated.

I'll keep you posted,

April

P.S. My FIL is currently falling anywhere from 8 to 16 times a

day. My poor MIL is worn completely out. Just being with my FIL

for 6 hours today wore me out. I don't know how she does it.

Welcome to LBDcaregivers.

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aswest1021 wrote:

> Anyhow, due to my FIL's memory problems and the fact that he has an

> active tremor, the doctor said he doesn't have " typical PD " . In

> fact, at this juncture, he's leaning towards Diffuse Lewy Body or

> Multiple Systems Atrophy (because he's having problems with urinary

> incontinence and constipation). So, he's ordered that my FIL

> undergo 4 hours of neuropsychological testing in 6 weeks and he's

> also ordered an MRI.

I am a medical and legal transcriptionist and one of my accounts is a

neuropsychologist who does this testing. I am going to ask her about

the clock test and LBD, and how her testing can be used in diagnosing

dementia (and if it can identify what kind of dementia one has). I'll

share what she says.

> He's going to wean my FIL off the Sinemet CR

> during the day over a period of the next three weeks. He said his

> philosophy with meds sometimes is that less is more.

WOW!! You have found a jewel of a physician. Keep him! He's totally

right about " less is more, " and certainly with elderly and those whose

systems are sensitive to medications, it is more common to see them

overmedicated than undermedicated. It is not unusual to find that too

much medication is creating symptoms or making symptoms worse,

especially cognitively.

> Does anyone here know anything about MSA? What is the prognosis, in

> comparison

> to LBD? Any info. would be much appreciated.

This was new to me, but I'm an old hand at Internet researchh. Here's a

bit of what I found at http://www.ninds.nih.gov/disorders/msa/msa.htm

which is the Web site for the National Institute of Neurological

Disorders and Stroke.

" Multiple system atrophy (MSA) refers to three slowly progressive

related disorders that affect the central and autonomic nervous systems.

The disorders are characterized by their foremost symptoms:

/olivopontocerebellar atrophy/ (OPCA), which primarily affects balance,

coordination, and speech; a parkinsonian form (/striatonigral

degeneration/), which can resemble Parkinson's disease because of slow

movement and stiff muscles; and a form with predominant autonomic

nervous system involvement (formerly /Shy-Drager/ syndrome, now called

MSA with orthostatic hypotension). In all three forms of MSA, the

patient can have orthostatic, or postural, hypotension-an excessive drop

in blood pressure when the patient stands up, which causes dizziness or

momentary blackouts. Other symptoms may include stiffness and rigidity,

loss of balance and coordination, impaired speech, breathing and

swallowing difficulties, blurred vision, male impotence, constipation,

and urinary difficulties. Most patients develop dementia late in the

course of the disease, which is usually diagnosed in persons over age

50. MSA is twice as common in men as in women. "

There's more at that site.

Also, check out http://www.emedicine.com/NEURO/topic671.htm. This is

written more for the medical professional but has great information.

More sites:

http://www.ndrf.org/MSA.htm (shorter and more to the point)

http://www.neurologychannel.com/msa/ (lots of information)

I hope this helps. It was interesting reading. I didn't see anything

that compared MSA with LBD, but I didn't read in depth yet (I'll go back

and do that). Thanks for sharing the doctor's opinion with us!

jacqui

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Just a heads up April, and not sure if I have told you this before, but I am

pretty sure it is

the Sinemet CR that did my mother in 4 years go, causing her " crash " from being

mobile to

wheelchair, fairly cognizant to a zombie. We brought her back noticeably

cognizantly,

never to walk again, with removal of the drug. Nasty!!!!!

At any rate perhaps you should let the doctor know how the visit affected your

father,

although I guess many seniors would be worn out after having to perform like

that. If he

knows Lewy Body, it might help a diagnosis.

All the best.

, Oakville Ont.

Mom 92, 12 1/2 years " Parkinsons "

3 1/2 years ago LBD diagnosis, evident much longer in hindsight.

Encouraged to give up her licence 6 years ago.

Currently immobile, in tilt wheelchair, spoonfed pureed food. Spends most of

days behind

closed eyes.

Eltroxin, Tylenol twice a day.

Off Aricept since Feb./06

>

> Hello Everyone,

>

> I just got home from the appointment my FIL had today with a

> neurologist at Emory for a second opinion. He put my FIL through a

> battery of tests to watch how he tracks his eyes from L to R and up

> and down. He did fairly well with that. He also had him subtract a

> series of numbers by 7 each time and he did well with that, too.

> The shocker came when my FIL was asked what month it was and he said

> May. He, then, was asked what year it was and he said it was 1974.

> I was completely stunned. He also didn't know the day of the week,

> but could tell the city and state he was in. He tested my FIL's

> mobility by having him walk with and without his walker.

> Surprisinly enough, he did relatively well. Of course, not long

> after we left the doctor's office, he got really bad. We went to a

> restaurant and three different men had to help him get seated and

> stand back up again. When we got back to my house, he fell

> backwards and fell into the garbage can, but didn't get hurt,

> thankfully.

>

> Anyhow, due to my FIL's memory problems and the fact that he has an

> active tremor, the doctor said he doesn't have " typical PD " . In

> fact, at this juncture, he's leaning towards Diffuse Lewy Body or

> Multiple Systems Atrophy (because he's having problems with urinary

> incontinence and constipation). So, he's ordered that my FIL

> undergo 4 hours of neuropsychological testing in 6 weeks and he's

> also ordered an MRI. He said those things should help him come to a

> definitive diagnosis. He's going to wean my FIL off the Sinemet CR

> during the day over a period of the next three weeks. He said his

> philosophy with meds sometimes is that less is more. Does anyone

> here know anything about MSA? What is the prognosis, in comparison

> to LBD? Any info. would be much appreciated.

>

> I'll keep you posted,

> April

>

> P.S. My FIL is currently falling anywhere from 8 to 16 times a

> day. My poor MIL is worn completely out. Just being with my FIL

> for 6 hours today wore me out. I don't know how she does it.

>

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Jacqui, thank you for the information, and I certainly will be looking

forward to your explanation of the clock, and other test, performed by Doctors.

Thank a bunch,

Imogene

Caregiver for my True Texas Gentleman husband of 35 years. He has AD and

possibly LBD, is Taking Aricept.

In a message dated 4/25/2006 6:13:16 PM Central Daylight Time,

jacquiwa@... writes:

aswest1021 wrote:

> Anyhow, due to my FIL's memory problems and the fact that he has an

> active tremor, the doctor said he doesn't have " typical PD " . In

> fact, at this juncture, he's leaning towards Diffuse Lewy Body or

> Multiple Systems Atrophy (because he's having problems with urinary

> incontinence and constipation). So, he's ordered that my FIL

> undergo 4 hours of neuropsychological testing in 6 weeks and he's

> also ordered an MRI.

I am a medical and legal transcriptionist and one of my accounts is a

neuropsychologist who does this testing. I am going to ask her about

the clock test and LBD, and how her testing can be used in diagnosing

dementia (and if it can identify what kind of dementia one has). I'll

share what she says.

> He's going to wean my FIL off the Sinemet CR

> during the day over a period of the next three weeks. He said his

> philosophy with meds sometimes is that less is more.

WOW!! You have found a jewel of a physician. Keep him! He's totally

right about " less is more, " and certainly with elderly and those whose

systems are sensitive to medications, it is more common to see them

overmedicated than undermedicated. It is not unusual to find that too

much medication is creating symptoms or making symptoms worse,

especially cognitively.

> Does anyone here know anything about MSA? What is the prognosis, in

> comparison

> to LBD? Any info. would be much appreciated.

This was new to me, but I'm an old hand at Internet researchh. Here's a

bit of what I found at http://www.ninds.nih.gov/disorders/msa/msa.htm

which is the Web site for the National Institute of Neurological

Disorders and Stroke.

" Multiple system atrophy (MSA) refers to three slowly progressive

related disorders that affect the central and autonomic nervous systems.

The disorders are characterized by their foremost symptoms:

/olivopontocerebellar atrophy/ (OPCA), which primarily affects balance,

coordination, and speech; a parkinsonian form (/striatonigral

degeneration/), which can resemble Parkinson's disease because of slow

movement and stiff muscles; and a form with predominant autonomic

nervous system involvement (formerly /Shy-Drager/ syndrome, now called

MSA with orthostatic hypotension). In all three forms of MSA, the

patient can have orthostatic, or postural, hypotension-an excessive drop

in blood pressure when the patient stands up, which causes dizziness or

momentary blackouts. Other symptoms may include stiffness and rigidity,

loss of balance and coordination, impaired speech, breathing and

swallowing difficulties, blurred vision, male impotence, constipation,

and urinary difficulties. Most patients develop dementia late in the

course of the disease, which is usually diagnosed in persons over age

50. MSA is twice as common in men as in women. "

There's more at that site.

Also, check out http://www.emedicine.com/NEURO/topic671.htm. This is

written more for the medical professional but has great information.

More sites:

http://www.ndrf.org/MSA.htm (shorter and more to the point)

http://www.neurologychannel.com/msa/ (lots of information)

I hope this helps. It was interesting reading. I didn't see anything

that compared MSA with LBD, but I didn't read in depth yet (I'll go back

and do that). Thanks for sharing the doctor's opinion with us!

jacqui

[Non-text portions of this message have been removed]

Welcome to LBDcaregivers.

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