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What Does This MRI Report Indicate?
Question: my mother has inability to walk she can walk a little bit by dragging her feet she can lift her feet when asked to do so MRI of brain shows shrinkage of brain she is also taking medicine for epilepsy epilex chromo 500 her hands shivers a little she is mentally alert now doctor adviced her to take SYNDOPAplus 125mg what to do please advice she is being looked by a neurologist
Brief Answer:
Please tell some more details:
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I understand your concern and I shall try to address them at best.As the treating neurologist has prescribed Syndopa plus,she is probably having Parkinson's disease,however,I need to know some more details to answer this well-
1)Does she have tremors in both hands or one hand?If in both hands-did they start asymmetrically(firstly in one hand and then as the illness progressed-in other hand) or symmetrically in both hands?
2)Does she have rest tremors or have them while doing some work with hands?
3)Does she have rigidity or tightness in limbs?
4)Has she developed slowness in doing activities of routine life?
I shall be glad to have you in follow-up with details so that I can answer this appropriately.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please tell some more details:
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I understand your concern and I shall try to address them at best.As the treating neurologist has prescribed Syndopa plus,she is probably having Parkinson's disease,however,I need to know some more details to answer this well-
1)Does she have tremors in both hands or one hand?If in both hands-did they start asymmetrically(firstly in one hand and then as the illness progressed-in other hand) or symmetrically in both hands?
2)Does she have rest tremors or have them while doing some work with hands?
3)Does she have rigidity or tightness in limbs?
4)Has she developed slowness in doing activities of routine life?
I shall be glad to have you in follow-up with details so that I can answer this appropriately.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The further details are
1.she has tremors in both hands symmetrically.
2.she has tremors of hands only while doing some work e.g. holding a plate to eat or glass to drink
3.she has rigidity of limbs or something else i.e.some time she cannot take step or even drag her feet while moving while sometime she can do it easily she will drag her feet but if i ask her to lift her foot she will do so take one or two normal steps then again start dragging her feet if there is an obstacle she will easily lift her foot and clear it e.g. if there are steps she will climb it
4.yes she has developed slowness in doing activities
further, she is an educated person still read newspaper,listen to news,read religious books but says sometime that she can not make out the meaning of whole of sentence.Otherwise she is still mentally alert,remember date,time ,day,month year etc.Still guiding us but sometimes, I think she is bit confused or afraid of something. kindly advice I am a prof.in chemistry and know that syndopa plus is a medison for perkinson but is she having it .The MRI of brain shows
Atrophic changes of brain parenchyma (supratentorial brain)
proportionate dilation of ventricular system
basal ganglia show calcification
there is prominence of extra axial sulcal spaces of b/l cerebral hemisphere and b/l sylvian fissures with proportional dilatation of ventricular system
rest is normal
I think this would be enough for you to kindly advice.
1.she has tremors in both hands symmetrically.
2.she has tremors of hands only while doing some work e.g. holding a plate to eat or glass to drink
3.she has rigidity of limbs or something else i.e.some time she cannot take step or even drag her feet while moving while sometime she can do it easily she will drag her feet but if i ask her to lift her foot she will do so take one or two normal steps then again start dragging her feet if there is an obstacle she will easily lift her foot and clear it e.g. if there are steps she will climb it
4.yes she has developed slowness in doing activities
further, she is an educated person still read newspaper,listen to news,read religious books but says sometime that she can not make out the meaning of whole of sentence.Otherwise she is still mentally alert,remember date,time ,day,month year etc.Still guiding us but sometimes, I think she is bit confused or afraid of something. kindly advice I am a prof.in chemistry and know that syndopa plus is a medison for perkinson but is she having it .The MRI of brain shows
Atrophic changes of brain parenchyma (supratentorial brain)
proportionate dilation of ventricular system
basal ganglia show calcification
there is prominence of extra axial sulcal spaces of b/l cerebral hemisphere and b/l sylvian fissures with proportional dilatation of ventricular system
rest is normal
I think this would be enough for you to kindly advice.
Brief Answer:
Kindly create a short video of herself walking and upload it.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.
Firstly about MRI,brain atrophy at her age is to be taken as a normal finding.All the findings as mentioned above are correlates of brain atrophy and are to be taken as physiological in elderly.
Regarding her gait,though I must say that you have tried to give a good description,however I feel the need to see her walking to make the diagnosis and I'm sure watching her walk will provide a definite clue to the diagnosis.So,I suggest that you should make a short video clip of herself walking and upload it on google drive.Please share the google drive link here in the follow-up so that I can view it and make the interpretation accordingly.
I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Kindly create a short video of herself walking and upload it.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.
Firstly about MRI,brain atrophy at her age is to be taken as a normal finding.All the findings as mentioned above are correlates of brain atrophy and are to be taken as physiological in elderly.
Regarding her gait,though I must say that you have tried to give a good description,however I feel the need to see her walking to make the diagnosis and I'm sure watching her walk will provide a definite clue to the diagnosis.So,I suggest that you should make a short video clip of herself walking and upload it on google drive.Please share the google drive link here in the follow-up so that I can view it and make the interpretation accordingly.
I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Please find below the link to the video on google drive, as asked above.
https://drive.google.com/open?id=0B2f1txyJg71udndjenlqZXJfWTA
Looking forward for your reply.
Regards
XXXX XXXXXXX
Please find below the link to the video on google drive, as asked above.
https://drive.google.com/open?id=0B2f1txyJg71udndjenlqZXJfWTA
Looking forward for your reply.
Regards
XXXX XXXXXXX
Brief Answer:
She has a parkinsonian gait.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I have watched the video you uploaded.She definitely has a parkinsonian gait and in fact,a classical one.It appears to be advanced stage of parkinsonian disorder.
However,physical examination will tell whether it is idiopathic parkinson disease(IPD) or some parkinson plus disorder.However,whatever be the diagnosis,Syndopa plus has to be started and response is to be observed.
Hope that I have answered your query.If you have some further questions,I shall be glad to be have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
She has a parkinsonian gait.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I have watched the video you uploaded.She definitely has a parkinsonian gait and in fact,a classical one.It appears to be advanced stage of parkinsonian disorder.
However,physical examination will tell whether it is idiopathic parkinson disease(IPD) or some parkinson plus disorder.However,whatever be the diagnosis,Syndopa plus has to be started and response is to be observed.
Hope that I have answered your query.If you have some further questions,I shall be glad to be have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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