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What Causes Persistent Closing Of Fingers In A Parkinson's Patient?
Question: My wife has parkinson on her left side. She has tremors in her left hand, which has caused the 4-finger to totally close as a fist. We have seen two orthopedic surgeons who say their is nothing that can be done, as she has feelings in her total arm. If their was numness they could do carpel-tunnel procedure or if was the deputens contracour of the hand they could operate and either give needle in the fingers or cut the tendons and straighen out her hand. Is their a procedure that would straighten out the fingers to make her hand normal. At the present time she is experiencing pain and has to take pain medication, which causes a lot of constipation and we have deal with that . She has been to the ER 3-times in the last 3- weeks because of severe pain.
Thank you XXXXXXX XXXXXXX
Thank you XXXXXXX XXXXXXX
Brief Answer:
Relevant treatment options provided.
Detailed Answer:
Hi Sir,
I understand your concern.
I have clearly gone through your mother's clinical presentation.
This persistent closing of the four fingers forming fist is referred to as Dystonia.
Dystonias are very common in Parkinson's disease.
More aptly these are referred to as Secondary focal dystonias.
These are caused as side effects of the drugs used in the treatment of Parkinsonism, particularly Levodopa and other dopamine agonist drugs..
The treatment of these dystonias in PD is difficult.But certain drugs and procedures can lead to marked improvement in symptoms.
I generally treat my patients with a combination of oral tablets- Clonazepam, Gabapentin and Neostigmine.Of late-Baclofen therapy seems successful.
I suggest you to please see a doctor if his views are same and if can prescribe these drugs for you.
Baclofen, given intrathecally by an implanted pump, can be very effective in certain types of dystonia, especially if spasticity coexists.Due to the low prevalence of side effects when the medicine is delivered into the cerebrospinal fluid, the ability to deliver the medicine continuously, and the ability to test the therapeutic effect prior to proceeding with surgery, this option may provide effective treatment for many patients.
Successful drug therapy often requires combinations of several medications, with choices generally guided by empirical trials and adverse effect profiles.
Doses should be slowly increased over the course of weeks or months until the therapeutic benefit is optimized or until adverse effects occur.
In most patients, discontinuation of the drugs requires tapering to prevent withdrawal symptoms.
Additionally Rehabilitative therapy is most important.It includes
1.Physical therapy techniques (eg, massage)
2.Slow stretching
3.Physical modalities (eg, ultrasonography, biofeedback).
4.Relaxation training.
5.Sensory stimulation.
You can discuss the above with your occupational physiotherapist for an expert guidance and successful outcome.
Post your further queries if any.
Thank you.
Relevant treatment options provided.
Detailed Answer:
Hi Sir,
I understand your concern.
I have clearly gone through your mother's clinical presentation.
This persistent closing of the four fingers forming fist is referred to as Dystonia.
Dystonias are very common in Parkinson's disease.
More aptly these are referred to as Secondary focal dystonias.
These are caused as side effects of the drugs used in the treatment of Parkinsonism, particularly Levodopa and other dopamine agonist drugs..
The treatment of these dystonias in PD is difficult.But certain drugs and procedures can lead to marked improvement in symptoms.
I generally treat my patients with a combination of oral tablets- Clonazepam, Gabapentin and Neostigmine.Of late-Baclofen therapy seems successful.
I suggest you to please see a doctor if his views are same and if can prescribe these drugs for you.
Baclofen, given intrathecally by an implanted pump, can be very effective in certain types of dystonia, especially if spasticity coexists.Due to the low prevalence of side effects when the medicine is delivered into the cerebrospinal fluid, the ability to deliver the medicine continuously, and the ability to test the therapeutic effect prior to proceeding with surgery, this option may provide effective treatment for many patients.
Successful drug therapy often requires combinations of several medications, with choices generally guided by empirical trials and adverse effect profiles.
Doses should be slowly increased over the course of weeks or months until the therapeutic benefit is optimized or until adverse effects occur.
In most patients, discontinuation of the drugs requires tapering to prevent withdrawal symptoms.
Additionally Rehabilitative therapy is most important.It includes
1.Physical therapy techniques (eg, massage)
2.Slow stretching
3.Physical modalities (eg, ultrasonography, biofeedback).
4.Relaxation training.
5.Sensory stimulation.
You can discuss the above with your occupational physiotherapist for an expert guidance and successful outcome.
Post your further queries if any.
Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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