PD or PSP

[DonQuijote]

How to differentiate PSP from PD?

[Kevin_1]

Hi DonQuijote

Welcome to the forum, sorry you are struggling with a neurological condition.

I've just seen your post over on the Parkinsoin's forum about language loss.

With PSP (I am unsure about CBD) there can be 'word finding' difficulties with ones native tongue and this can become quite severe. It does not affect comprehension though. So your difficulty with Spanish could well be part of that.

Loosing words is not diagnostic of PSP. Any neurological disorder affecting that part of the brain could cause that loss.

PSP is often mistaken for Parkinson's earlier on. A brain scan might differentiate the two, I believe Parkinson's does not exhibit slow saccades which PSP and CBD do.

There are currently some ?eight different PSP/CBD diagnoses found in post mortem research, but difficult to diagnose in vivo. One of them is PSP Parkinson's. This is PSP with more Parkinson's cross over than the other kinds. The disorder can respond for a while to Parkinson's medication whereas the other kinds do not. The meds. do not slow the disease, but merely ease some of the symptoms.

A trip to a movement disorder specialist. or neurology specialist, is the only way of getting clarification. Though even then mis-diagnoses can occur. Researchers are working on finding definitive bio-markers in order to get more certainty of diagnosis. At the moment the only sure way is post mortem examination.

Here is a link in answer to your question.

ninds.nih.gov/Disorders/Pat...

I hope this helps a little. Do come back if you want more info. or clarification.

Best

Kevin

[Dadshelper in reply to Kevin_1]

Dad, CBD, used to "word search" quite a bit when he was still able to talk. Sometimes he'd say a word that didn't fit with what he was saying and when asked he would state "that's not the word I want"

Ron

[Kevin_1 in reply to Dadshelper]

Hi Ron

What an interesting way to go.

Liz would point and gesture... never thought of word search.

Learning all of the time

[raincitygirl in reply to Dadshelper]

Ron, my CBD hubby did exactly the same...

Anne G

[DonQuijote in reply to Kevin_1]

Thanks Kevin

[Kevin_1 in reply to DonQuijote]

No worries.

It must be tough.

Wishing you the best.

Kevin

[LuisRodicioRodicio]

Hi DonQuijote!

I am sorry a neurological condition has entered their lives.

I'm not a doctor. I´m caregiver of a PSP-RS patient.

I shall comment now what I have read:

There is a type of PSP called Parkinsonism (PSP-P) whose symptoms are very similar to PD in the begining. I have read that in PSP-P there is no fall of the Blood Pressure and in PD it occurs.

The medication for PD (Carbidopa / Levadopa / Sinemet) works for PSP-P for at least 4 years improving normally the bradykinesia and rigidity. Then the medications stop acting progressively and the patient is showing the typical symptoms of a PSP type (PSP-RS, PSP-CBS, etc).

If you want, by private internal mail I shall send you our experiences with PSP-RS if you think could be useful to you.

Hug and luck.

Luis

[wear1947 in reply to LuisRodicioRodicio]

Thanks Luis. PSP-P is exactly the description of my sister. Instead of 4 years in her case Levodopa helps during 8 years. Noew she is in PSP freeze of gate

[LuisRodicioRodicio in reply to wear1947]

If physicians agree that there is suspicion of a Parkinson-like neurological disease (PSP-RS, PSP-CBS, PSP-P etc.), then I suggest to start an intensive and systematic exercise program including walking, up and down stairs, speech therapy, etc. as soon as possible, trying to slow down eventual muscle dysfunction. (Bearing in mind that Parkinsonian patients become significantly more fatigued (parallel to disease progression) for the same activities than those not sick, then they require more frequent rest periods.)

Hugs.

[wear1947 in reply to LuisRodicioRodicio]

Totally agree. I believe that the intensity of physical activity and its adaptation as capacities diminished is what allowed it to reach here. Currently, she can lift her eyelids until one month after the injection of Botox, the effect decreases to zero when the next Botox injection arrives. We saw 2 months ago, a decrease in the volume of the left parietal region together to the right leg claudication. Also, a large increase in the stiffness of the left leg. This combo generates many falls, almost once a day since last month.

His house is full of bars to grab, but sometimes she falls, either gripped, because the right leg does not bear her weight. She does not want to be confined to a wheelchair. She assumes the risk of falling. I will buy a skateboard helmet, to diminish risks.

That is all.

Hugs

[LuisRodicioRodicio in reply to wear1947]

Thank you for sharing your experience.

This is our experience with falls:

It is normal for the patient to resist using a wheelchair but regrettably that exercise of courage usually leads to falls and some of them will end up being serious.

Avoid falls and hits: Learn transfer techniques. Gait belt with handles (cloth loops) to grip, walker, cane, Replace breakables with non-breakable items wherever possible.Make sure there are no tripping hazards (carpets, etc.). Put foam corner guards on any square corners that patient could fall on, like shelves, tables, coffee tables, etc. Adapt the floor, shower, toilet and washbasin as soon as possible.

Set up handrails on each side of the bed. Make use of an articulated bed. Also think to use a plastic wheelchair (type ETAC) special for hygiene and shower.

My wife has regularly used a wheelchair since June 2016 (abrupt decline four and a half years after the onset of the first symptom and after the hip fracture and the corresponding surgical intervention). The wheelchair is made of aluminum and is foldable, easily transportable in the car trunk (aluminum wheelchair is Ergo Lite 2 from KARMA brand).

After each fall episode I have perceived a greater fear of falling which produces greater rigidity and some distrust towards the caregivers.

After hip fracture no more falls but steady progression of PSP symptoms.

Hugs.

Luis

[wear1947 in reply to LuisRodicioRodicio]

Dear Luis, thanks for the tips.

Hugs

Elena F.

[DonQuijote in reply to LuisRodicioRodicio]

Thanks Luis

[rriddle]

There is a helpful video that answers your question. Brain Support Network has taken extensive notes on the video, in case you don't want to watch it. Note in particular the section on ALERT, which is how neurologists can differentiate PSP (and the other atypicals) with PD.

brainsupportnetwork.org/edu...

[DonQuijote in reply to rriddle]

Thank you very much it's an extremely useful site .