Just found your channel and hope it's ok to ask a question. I have symptoms that suggest MSA; loss of balance, falls, tremors, constipation, erratic blood pressure, tinnitus, etc. HOWEVER, I also have periods of days, weeks, even months with no or only occassional very slight symptoms, feeling 95% normal. I haven't found anything that addresses this. Is this common with MSA?
It could happen in early stages. Sometimes lack of sleep can exacerbate symptoms. See a movement disorders specialist. We can assess earlier if this is in fact the issue.
@@TheParkinsonsDoctor Thank for helping me on this. Since I made that post I've been through genetic testing and there were no markers that would suggest neurologic issues. I don't really know how definitive that is; my neurologist is difficult to set an appointment with. But it makes me wonder is we've been barking up the wrong tree.
Wouldn't pathologic evidence of alpha-synucleinopathy coupled with signs and symptoms of MSA be indicative of MSA versus PD and especially if the patient isn't responding to Levodopa?
Let's suppose a patient came to you with the following profile, I'd like to know what your next step would be? Patient X diagnosed with PD in 9/21 has a history of poor response to C/L. Receives weekly PT and SP services, exercises regularly 4-5 days . In the last 6 months, patient X has declined due to falling (at least 12 times, only once with minor injury),diagnosed with OH 12/23, incontinence (urinary all the time, bowel occasionally). Can't walk without rollator and has a pronounced leaning to the right. Speech and vocal changes, doesn't swallow unless cued by accumulated saliva, drooling. Patient X comes to see you and relates all this to you. What's your next step for patient X?
These cases are very difficult and as a physician, heartbreaking. Looks like you are a healthcare professional with your description. This is a general response of how I handle these cases. This is not medical advice. The lack of response to levodopa and the rapid progression suggests an atypical Parkinson syndrome if the cardinal symptoms are present, such as rigidity, bradykinesia and postural instability. You did not mention tremors. The presence of OH suggests an autonomic involvement. I would check MRI of the Brain to assess for NPH, maybe the Syn-One Biopsy to confirm the presence of alpha synuclein to confirm this is a synucleinopathy rather than a tauopathy (PSP, CBD, etc). Depending on the results, and lacking hallucinations, I’ll have the diagnosis. PT, OT, Speech, Diet, Meditation are critical. I’d recommend to Focus on quality rather than quality. I’m bringing a video Monday discussing the Syn-One Test.
Thank you for your work. My wife had MSA-c. Symptoms started at 16. She lived to 44. More research needs to be done. We went through all of this, barely knowing anything. An MRI showed us that the Cerebellum was deteriorating, but anything more than that was up in the air. The National Ataxia Foundation has resources and information for anyone who needs help.
MSA is very challenging and the currently available treatments are mostly supportive. However, there is a new research study you might check as an option to participate. Check: alteritytherapeutics.com/investor-centre/news/2023/01/09/alterity-therapeutics-launches-ath434-phase-2-clinical-trial-in-the-united-states-for-the-treatment-of-individuals-with-multiple-system-atrophy/
Just found your channel and hope it's ok to ask a question. I have symptoms that suggest MSA; loss of balance, falls, tremors, constipation, erratic blood pressure, tinnitus, etc. HOWEVER, I also have periods of days, weeks, even months with no or only occassional very slight symptoms, feeling 95% normal. I haven't found anything that addresses this. Is this common with MSA?
It could happen in early stages. Sometimes lack of sleep can exacerbate symptoms. See a movement disorders specialist. We can assess earlier if this is in fact the issue.
@@TheParkinsonsDoctor Thank for helping me on this. Since I made that post I've been through genetic testing and there were no markers that would suggest neurologic issues. I don't really know how definitive that is; my neurologist is difficult to set an appointment with. But it makes me wonder is we've been barking up the wrong tree.
Wouldn't pathologic evidence of alpha-synucleinopathy coupled with signs and symptoms of MSA be indicative of MSA versus PD and especially if the patient isn't responding to Levodopa?
Correct. Especially if no hallucinations.
I appreciate the information. My husband is suspected to have MSA-P. There isnt a lot of information out there. Please keep the videos coming.
Glad it was helpful!
Let's suppose a patient came to you with the following profile, I'd like to know what your next step would be? Patient X diagnosed with PD in 9/21 has a history of poor response to C/L. Receives weekly PT and SP services, exercises regularly 4-5 days . In the last 6 months, patient X has declined due to falling (at least 12 times, only once with minor injury),diagnosed with OH 12/23, incontinence (urinary all the time, bowel occasionally). Can't walk without rollator and has a pronounced leaning to the right. Speech and vocal changes, doesn't swallow unless cued by accumulated saliva, drooling. Patient X comes to see you and relates all this to you. What's your next step for patient X?
These cases are very difficult and as a physician, heartbreaking. Looks like you are a healthcare professional with your description. This is a general response of how I handle these cases. This is not medical advice. The lack of response to levodopa and the rapid progression suggests an atypical Parkinson syndrome if the cardinal symptoms are present, such as rigidity, bradykinesia and postural instability. You did not mention tremors. The presence of OH suggests an autonomic involvement. I would check MRI of the Brain to assess for NPH, maybe the Syn-One Biopsy to confirm the presence of alpha synuclein to confirm this is a synucleinopathy rather than a tauopathy (PSP, CBD, etc). Depending on the results, and lacking hallucinations, I’ll have the diagnosis. PT, OT, Speech, Diet, Meditation are critical. I’d recommend to Focus on quality rather than quality. I’m bringing a video Monday discussing the Syn-One Test.
@TheParkinsonsDoctor Patient X has an appointment with you on 3/25/24 and Patient X is me
Thank you for your work. My wife had MSA-c. Symptoms started at 16. She lived to 44. More research needs to be done. We went through all of this, barely knowing anything. An MRI showed us that the Cerebellum was deteriorating, but anything more than that was up in the air. The National Ataxia Foundation has resources and information for anyone who needs help.
Agree. Thanks for sharing. I have many patients as you describe and it is quite challenging.
Ive never heard of MSA in a 16 year old and to live for over 25 years@@TheParkinsonsDoctor
Pl.suggest some treatment for MSA.
MSA is very challenging and the currently available treatments are mostly supportive. However, there is a new research study you might check as an option to participate. Check: alteritytherapeutics.com/investor-centre/news/2023/01/09/alterity-therapeutics-launches-ath434-phase-2-clinical-trial-in-the-united-states-for-the-treatment-of-individuals-with-multiple-system-atrophy/