MSA/LBD Diagnosis

[Guest guest]

I have been a member here for a little over a year and joined when my Mom's

Parkinson's diagnosis was revised to LBD. Now, over a year later, her

neurologist is re-diagnosing her again, this time with MSA (Multiple Systems

Atrophy). Her dementia does not fit the MSA profile, but she has every other

box checked, and her dementia is not progressing at the rate that her

neurologist feels she would with straight LBD. Her most prominent disability at

this time is her wide ranging blood pressure, falling to as low as 74/38 (this

morning's) to a high of 187/94 (when lying down). Most are not that high nor

that low, but rarely are they in the middle anymore, ever. (Mom's bp used to be

stable at about 100/65.) Incontinence is also a very big problem, along with

walking, although surprisingly she can sometimes walk even when her pb is in the

80's over 50's. Mom had a master's degree from Columbia and still " reads " the

New Yorker and has a phenomenal vocabulary, but completely fails the mini-mental

tests. She is not delusional, although she has vivid dreams and talks in her

sleep all the time. How can she not be able to write, or tell you the town she

lives in, but be able to talk relatively cogently about the crisis in Egypt or

health care reform? Are these simply neurological pathways so heavily used

throughout her life that they are retained? She is on namenda and aricept and

an antdepressant, but very little Sinemet now, just a half tab three times a

day, and her tremors have almost completely disappeared, although her walking

difficulties are partially complete lack of muscle control sometimes and

sometimes a version of gait freezing. Sometimes she has seizure type events

like described in a recent post where she goes catatonic and slumps forward.

The doctors think this is a sudden drop in bp but by the time we take her blood

pressure it is usually up in the range of low normal or even high normal for her

and they speculate that her body has responded to the sudden drop with a sudden

uptick. Anyone have any experience or thoughts on any of this? (By the way, two

low blood pressure medications were discontinued because they made her highs too

high.)