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What Causes Progressive Supranuclear Palsy?
Question: I have progressive supranuclear palsy. Can Mayo help me ?
Brief Answer:
PSP a challenge for any clinic.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
Mayo clinic is indeed considered one of the best in the world so I understand your hope of receiving better help from their staff. Unfortunately though progressive supranuclear palsy is a condition which management remains challenging for any neurologist even at Mayo's.
As your neurologist says there research on the field is fairly new and up to now hasn't produced any course altering medication, the carbidopa/levodopa benefit is very modest and temporary, so is the effect of other drugs which have been tried like bromcriptine, antidepressants, trazodone, amantadine, coenzyme Q10.
So while you can still go to Mayo for a second opinion in order to confirm the diagnosis, you must be prepared for the fact that if in conclusion the diagnosis remains the same, there is not much more than what you already get that they can offer you .
I remain at your disposal for further questions.
PSP a challenge for any clinic.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
Mayo clinic is indeed considered one of the best in the world so I understand your hope of receiving better help from their staff. Unfortunately though progressive supranuclear palsy is a condition which management remains challenging for any neurologist even at Mayo's.
As your neurologist says there research on the field is fairly new and up to now hasn't produced any course altering medication, the carbidopa/levodopa benefit is very modest and temporary, so is the effect of other drugs which have been tried like bromcriptine, antidepressants, trazodone, amantadine, coenzyme Q10.
So while you can still go to Mayo for a second opinion in order to confirm the diagnosis, you must be prepared for the fact that if in conclusion the diagnosis remains the same, there is not much more than what you already get that they can offer you .
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Taka: I am writing this at the request of my wife, XXXX. She is going blind......We thank you for your letter of yesterday. From what I read that you have said, that a second opinion would probably give the same diagnosis?
My next question is...................does Mayo's clinic dialogue with neurologist's at XXXXXXX and White Clinic in Temple, XXXXXXX if a request was made?
Would these consultations be covered by Medicare and AARP supplement if these consultations were allowed between the two clinics? Your answer asap will certainly be appreciated. Thank you.....XXXX, for XXXX, email, YYYY@YYYY .
My next question is...................does Mayo's clinic dialogue with neurologist's at XXXXXXX and White Clinic in Temple, XXXXXXX if a request was made?
Would these consultations be covered by Medicare and AARP supplement if these consultations were allowed between the two clinics? Your answer asap will certainly be appreciated. Thank you.....XXXX, for XXXX, email, YYYY@YYYY .
Brief Answer:
Read below.
Detailed Answer:
Thank you for the feedback.
Whether a second opinion would give the same diagnosis is difficult to say with confidence as PSP is first and foremost a clinical diagnosis, there are no lab tests or imaging tests which make the diagnosis (imaging helps but only when correlated with signs), it's physical examination and history which is vital. So I can say that history is compatible with PSP diagnosis but physical exam findings are necessary as well.
Regarding you additional question, it is a little difficult to say for me as I exercise in Europe so insurance regulations and practice differ. I can say from what I have read that you can make the appointment yourself and take ask your doctor for a summarizing letter on your wife's condition, medical records and tests. Afterwards if the staff at Mayo will need further information they will contact your doctor.
As for the Medicare issue, while part A of Medicare plan (inpatient hospital services) is covered, Part B for outpatient hospital services, doctors fees, clinic services is not, although that part will be filed on your behalf as well and Medicare will help with you having to fill the remaining balance.
However as I said I am not well familiar with insurance practices, the info I just mentioned was from the Mayo website, you might check it yourself.
I hope things will work out for the best.
Read below.
Detailed Answer:
Thank you for the feedback.
Whether a second opinion would give the same diagnosis is difficult to say with confidence as PSP is first and foremost a clinical diagnosis, there are no lab tests or imaging tests which make the diagnosis (imaging helps but only when correlated with signs), it's physical examination and history which is vital. So I can say that history is compatible with PSP diagnosis but physical exam findings are necessary as well.
Regarding you additional question, it is a little difficult to say for me as I exercise in Europe so insurance regulations and practice differ. I can say from what I have read that you can make the appointment yourself and take ask your doctor for a summarizing letter on your wife's condition, medical records and tests. Afterwards if the staff at Mayo will need further information they will contact your doctor.
As for the Medicare issue, while part A of Medicare plan (inpatient hospital services) is covered, Part B for outpatient hospital services, doctors fees, clinic services is not, although that part will be filed on your behalf as well and Medicare will help with you having to fill the remaining balance.
However as I said I am not well familiar with insurance practices, the info I just mentioned was from the Mayo website, you might check it yourself.
I hope things will work out for the best.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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