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What Causes Slow Speech Rate?
Question: Sir,
I am suffering from movement problems since two years, associated with lowering of speech particularly at end of the day. while seating there is a tendency fall back.
Gradually problems are increasing.
As per doctor's advice I am taking four nos syncapone 150 and Pramipex ER 0.375, but even after taking these medicines also there is no improvements.
I need advice from experts in this field.
I am suffering from movement problems since two years, associated with lowering of speech particularly at end of the day. while seating there is a tendency fall back.
Gradually problems are increasing.
As per doctor's advice I am taking four nos syncapone 150 and Pramipex ER 0.375, but even after taking these medicines also there is no improvements.
I need advice from experts in this field.
Brief Answer:
Medicines dose need to be adjusted.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. Based on this, I presume you have been diagnosed to have Parkinson's disease (PD). In PD, MRI of brain is normal. If we want to do a brain scan for confirmation of PD, it should be PET scan (positron emission tomography), which would show reduced function of substantia nigra (basal ganglia) of brain. PET scan is not available in many places, and it is not a must for diagnosis of PD. Clinical examination by a neurologist is enough to make a correct diagnosis.
You are on correct medicines for PD, however, the dose of Pramipex needs to be increased. It can be slowly increased under the guidance of a neurologist.
Lowering of speech in evenings can also occur in another disease called myasthenia gravis. This can be excluded by doing a test called repetitive nerve stimulation by the neurologist.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Medicines dose need to be adjusted.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. Based on this, I presume you have been diagnosed to have Parkinson's disease (PD). In PD, MRI of brain is normal. If we want to do a brain scan for confirmation of PD, it should be PET scan (positron emission tomography), which would show reduced function of substantia nigra (basal ganglia) of brain. PET scan is not available in many places, and it is not a must for diagnosis of PD. Clinical examination by a neurologist is enough to make a correct diagnosis.
You are on correct medicines for PD, however, the dose of Pramipex needs to be increased. It can be slowly increased under the guidance of a neurologist.
Lowering of speech in evenings can also occur in another disease called myasthenia gravis. This can be excluded by doing a test called repetitive nerve stimulation by the neurologist.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your Dr. XXXXXXX XXXXXXX Regarding PET Scan I have few queries which are furnished below.
1. whether there are any adverse effects on body.
2. how effective PET scan is over TRODAT SCAN?
My physician in XXXXXXX suggested me for increase of doses of syncapone to 5 nos of 150 from 5 nos of 150 as well as for Pramipex 3 nos 0.5 from 3 nos. 0.375.
Waiting for your advice.
1. whether there are any adverse effects on body.
2. how effective PET scan is over TRODAT SCAN?
My physician in XXXXXXX suggested me for increase of doses of syncapone to 5 nos of 150 from 5 nos of 150 as well as for Pramipex 3 nos 0.5 from 3 nos. 0.375.
Waiting for your advice.
Brief Answer:
Agree with the dose changes.
Detailed Answer:
Thank you for getting back.
1. PET scan exposes the body to a small dose of radiation. Radiation is known to increase the risk of cancers. Radiation exposure occurs with X-rays and CT scans too. However, the dose of a single PET scan is too low to be worried about it causing cancer.
2. PET and SPECT are both good for the diagnosis of PD and ruling out conditions that can mimic PD. SPECT is cheaper than PET, however, accuracy may be slightly lesser than PET too.
3. I agree with the changes in the dose of medicines.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Agree with the dose changes.
Detailed Answer:
Thank you for getting back.
1. PET scan exposes the body to a small dose of radiation. Radiation is known to increase the risk of cancers. Radiation exposure occurs with X-rays and CT scans too. However, the dose of a single PET scan is too low to be worried about it causing cancer.
2. PET and SPECT are both good for the diagnosis of PD and ruling out conditions that can mimic PD. SPECT is cheaper than PET, however, accuracy may be slightly lesser than PET too.
3. I agree with the changes in the dose of medicines.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Dr. XXXXXXX XXXXXXX I would like to get your opinion for my early morning difficulties.
In the morning I feel pain around my lumber 5 zone, where I was diagnosed to have sacralisation when I was 35 years old. Till 62 years of my age I have managed with exercises. But now those exercises are not so effective.
My question can PET diagnose this difficulties in my spine or other parts of the body.
I will thankful for getting your opinion.
Best regards,
XXXXXXX XXXXXXX Mukhopadhyay
In the morning I feel pain around my lumber 5 zone, where I was diagnosed to have sacralisation when I was 35 years old. Till 62 years of my age I have managed with exercises. But now those exercises are not so effective.
My question can PET diagnose this difficulties in my spine or other parts of the body.
I will thankful for getting your opinion.
Best regards,
XXXXXXX XXXXXXX Mukhopadhyay
Brief Answer:
MRI spine is needed for evaluation of back.
Detailed Answer:
Thank you for getting back.
PET scan is not useful for evaluation of back problems. If the problems are disturbing, then, an MRI of lumbar spine should be done.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
MRI spine is needed for evaluation of back.
Detailed Answer:
Thank you for getting back.
PET scan is not useful for evaluation of back problems. If the problems are disturbing, then, an MRI of lumbar spine should be done.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Remy Koshy
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