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Suggest Treatment For Slurred Speech, Muscular Pain In Right Shoulder And Arm

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Posted on Thu, 3 Dec 2015
Question: Hi can somebody, please suggest about illness of my mother (52 yrs)..as she is in such medical condition since 9-10 months..we have consulted to various nuro. spec. doctors but nobody is even able to diagnose the situation..
2 MRI has been taken,2EEG taken and 2 blood test (1 was widal test 2 was KFT normal) with ultrasound (normal) and chest exray(normal)
Current health condition includes below issues:
1-she is not able to speak properly slurring is there, can only speak about 30-40% of her abilty.
2-she has pain in right shoulder and arm, seems muscular pain, 2 month physiotherapy was done by doctors,but currently doing at home by family members.
Sometimes she complains in both shoulders.
3-she doesn't seem to see straight when talking to some one.. Pupil doesn't seem moving. her lids are down and 40-50% open, blink ratio seems below normal
4-Her both hand doesn't move she walks.
5-She can only take some baby steps to walk.
6-1 and half month back typhoid was detected and treatment was continued and cured after then but she is more slow since then after recovering typhoid.
7-she can recall things perfectly, but sometimes she stuck with only one thing while saying like arguing probably she is not able to speak clearly or she is adamant due to this medical condition.
8-she can laugh she is able to understand jokes and everything but due to this medical condition she has become more emotional, when somebody new ,ask her about medical condition she starts crying, seems her moral has been down severely due to conditions.
9-in 3 week back MRI shows small calcified granulomatous lesions without any perilesional edema left parietal lobe. neurocysticercosis stage IV mild sphenoid and ethmoid sinusitis.
10- last 5 days back EEG shows- Prominent beta over activity s/o neuronal hyperexitabilty. However no dependent seizure activity.
doctor
Answered by Dr. Neeraj Kumar (18 minutes later)
Brief Answer:
Seems to be parkinsonism

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
Your mother seems to be suffering from degenerative brain disease most likely parkinsonism with frontal lobe involvement also.
Paucity of movement, decreased arm swing, decreased blink rate, mask like facies, Joint stiffness are features of parkinsons disease.
You need to consult a good neurologist or movement disorder expert for full detailed examination, investigation and treatment accordingly.
The treatment response to various types of parkinsonian disorder are varied.
The prognosis and treatment can only be explained once the diagnosis is made.
You can upload previous prescription, report and Mri images for evaluation.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neeraj Kumar (3 hours later)
Thanks Sir, For your precious advice... By google search I had doubt that it may be the case of Parkinsonism, specialists doesn't suggest any concrete cause earlier. Now by your expert guidance we can try follow ups in that direction. As earlier all specialist suggested us that it may the result of severe depperession, anxiety as 10 month earlier my sister got married after a lot of struggles. Also work in XXXXXXX MH XXXXXXX and my father go to office.. So she basically remains alone at home, probably loneliness put her in such situation.( P:S mom and dad currently leaving XXXXXXX U.P, India)
10 months earlier we started noticing such symptoms of her during my sister marraige time. these were light symptoms at that time though. By time passage, with to many neuro spec. her condition got serious day by day.

I'll try uploading paper reports as well, however for MRI scans and X-rays, I have no idea about to copy and upload them, I'll share paper scanned report though.

In my last post I forgot to mentioned below points.
1- my mothers hands shake visibly, when she try to work.
2- she feel difficulty to hold spoon, pen or any other object, in short her hands hold is not firm.
3- she feels difficulties in sitting up and down.
Please suggest me if it is curable or subdued entirely with medications. Also any test that we can go for other than MRIs, to make it sure that it is case Parkinson's deases.

Also please suggest me your time availability/venue/ contact details so that we could take and prior appointment to visit you in person if required.

Before that I'll try to send you all paper prescriptions and reports to be more accurate online diagnose.

Many thanks,
Best Regards, XXXXXXX Arya
doctor
Answered by Dr. Neeraj Kumar (3 hours later)
Brief Answer:
visit a neuro-center for evaluation

Detailed Answer:
Hello XXXXXXX XXXXXXX
Parkinsonian disorders are of many types.
Idiopathic parkinson's disease is characterised by unilateral onset , resting tremors with or without action, stiffness or rigidity, slowness of movement and slow progression.
In other varieties of parkinsonism symmetrical onset, early gait difficulties and fall or urinary complains or autonomic involvement with rapid course may occur.
Other comorbid conditions also have additional burden like diabetes , hypertension, stroke, hypothyroidism, vitamin b12 deficiency and depression.
you need to visit a good institute of neurocentre for detailed clinical examination and investigation for treatment of disease.
The treatment of these disorders are controllable on drugs but not cured except for hypothyroidism, vitamin b12 deficiency and depression.
In XXXXXXX you can get expert doctors in various hospital like SEVEN hills, apollo, Hinduja hospitals.
you can upload reports as pdf and mri images as pdf after taking clear photos.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Treatment For Slurred Speech, Muscular Pain In Right Shoulder And Arm

Brief Answer: Seems to be parkinsonism Detailed Answer: Hello XXXX, I have gone through your question and understand your concerns. Your mother seems to be suffering from degenerative brain disease most likely parkinsonism with frontal lobe involvement also. Paucity of movement, decreased arm swing, decreased blink rate, mask like facies, Joint stiffness are features of parkinsons disease. You need to consult a good neurologist or movement disorder expert for full detailed examination, investigation and treatment accordingly. The treatment response to various types of parkinsonian disorder are varied. The prognosis and treatment can only be explained once the diagnosis is made. You can upload previous prescription, report and Mri images for evaluation. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr Neeraj Kumar Neurologist