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Will A Syndopa Trial Be Helpful In A Patient Diagnosed With PSP?

Posted on Sat, 11 Jul 2015

Question: My mom has bn by n large bed ridden fr th past 5 yrs due to neuro -ortho disorders as diagnosed in 2008. In 2009 sh developed falling tendencies n started using stick n subsequently a walker. Since 2013, sh hs bn only wheel chair bound as walking with th walker too became difficult. Aftr many neuro visits, last year she was diagnosed as having MSA bt no dopamine was prescribed. Last month sh was diagnosed as PSP n low dozes of sandopa hv bn prescribed. I want to know that at this stage do v administer th drug? Wld it benefit her?. Wl sh b able to take the side effects? Pl gv me ur honest opinion as mom is getting very rigid n sluggish. Sh already suffers frm severe respiratory disorders. Her speech hs gone n there is hyper salivation. Many doctors earlier on have diagnosed th prob as slow motor neuron. Thanx a ton

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Syndopa trial should be given.

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I offer my heartiest concerns for your mother and pray to God for the best in store for her.
Of course,She is through a severe disease-be it MSA? or PSP? Both of them are neurodegenerative disorders with poor prognosis and both of them respond poorly to Syndopa.Inspite of that,it is a protocol that every parkinsonian disorder should be given a trial of Syndopa,atleast. We don't want to miss those rare cases of parkinson's plus disorders who respond to Syndopa.If she responds to Syndopa,her life will get easier.
So,if such a patient arrives at my outpatient,even I would give a trial of Syndopa.There can be some side effects but we don't want to lose upon effects for the risk of side effects.If side effects occur,they can be managed well.

The bottom line is-'You don't have much to do.So,do atleast what you can do'.

Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (14 hours later)

In case we do not want to give syndopa, would it make any difference? I hv been told that with or without syndopa, life for her will not change. Side effects like digestive track disorder n nausea could be tough on her as sh already suffers from bad piles n sits on th commode for hours together. She is very fragile. Her MRI spine n brain are vry bad. Sh hs many ischimia patches n her L1 L2 L4 r all damaged. Weighing th pros of cons of syndopa and no syndopa scenarios, please tell me which would be better?

Answered by Dr. Ajay Panwar (4 hours later)

Brief Answer:
Trial of syndopa may be given.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

I suggest that a trial of syndopa should be given.If there is no significant useful effect,it can be stopped.Or,if side effects are troublesome,it can be stopped.

It deserves a trial in a parkinsonian disorder.

Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar