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Diagnosed With Vascular Parkinsonism. Taking Ecosprin And Syndopa Plus. Chances Of Recovery?

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Posted on Tue, 11 Jun 2013
Question: My Dad is diagnosed with vascular parkinsonism...80 yrs old ..he's put on ecosprin and syndopa plus....he's had small strokes and is not mobile now.....can he recover his movements?
doctor
Answered by Dr. Sudhir Kumar (50 minutes later)
Hi Mr XXXXXXX

Thank you for posting your query.

Vascular Parkinsonism refers to the condition in which a patient has clinical features and problems mimicking Parkinson's disease (PD) but the underlying cause is vascular (due to lack of blood flow to brain). This is unlike PD, which is a degenerative disease.

Typically, one sees a gradual deterioration in patients with PD, without any recovery. However, in vascular Parkinsonism, partial recovery occurs. Coming back to your dad's case, we do expect improvement in mobility with medications and physiotherapy. Complete or excellent improvement, however, generally does not occur.

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (5 hours later)
His doc has advised to start 1/4th BD -Syndopa plus. If this is not parkinsons then why give him this drug. He is alos given 75 mg ecospirin. Any other medication we can give to speed recovery of movement ??
doctor
Answered by Dr. Sudhir Kumar (2 hours later)
Thank you for getting back with more details.
As you thought, syndopa works best in Parkinson's disease. In cases mimicking PD (Parkinsonism), it does not work so well, however, minor improvements are noted. Also, typically lower doses are given (for example, in PD, we would begin with one tablets twice daily).

Ecosprin is the main drug here, which would ensure that further reduction in blood supply of brain does not occur (no new brain strokes develop).

No other medications are helpful in this condition.

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (47 minutes later)
Thanks. Really helpful. A quick one. His sleep study shows spo2 level dropping to 80 when he sleeps. Wil addressing his sleep apnea with cpap machine etc increase his recovery / reduce stroke chances / reduce blood pressure ???
doctor
Answered by Dr. Sudhir Kumar (52 minutes later)
This is a really excellent question! (A distinction even for a DM Neurology student!)

Coming back, yes, sleep apnea is a risk factor for both high BP and brain stroke. So, treating sleep apnea would reduce his BP and risk of stroke recurrence.

However, to demonstrate sleep apnea, there should be apneic spells (complete cessation of breathing for a few seconds) and not just drop in spo2 levels (what I mean is that drop in spo2 alone is not enough to make a diagnosis of sleep apnea). If I presume that sleep study has confirmed sleep apnea, CPAP machine would be useful.

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir Kumar

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Diagnosed With Vascular Parkinsonism. Taking Ecosprin And Syndopa Plus. Chances Of Recovery?

Hi Mr XXXXXXX

Thank you for posting your query.

Vascular Parkinsonism refers to the condition in which a patient has clinical features and problems mimicking Parkinson's disease (PD) but the underlying cause is vascular (due to lack of blood flow to brain). This is unlike PD, which is a degenerative disease.

Typically, one sees a gradual deterioration in patients with PD, without any recovery. However, in vascular Parkinsonism, partial recovery occurs. Coming back to your dad's case, we do expect improvement in mobility with medications and physiotherapy. Complete or excellent improvement, however, generally does not occur.

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad