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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Adverse Reactions To Changed Parkinson’s Medication After A Fall Be Treated?

Help! My husband has Parkinson and recently fell and now has a small tear in the cartilage of his left hip. He was in the hospital over night and after coming home could not get off his chair because of the pain. He is now in a nursing home for extensive therapy and is doing terrible with his mental stability, seems to be over medicated, acts like the energizer bunny taking his carbalopa/lev 25/100 (a different generic from the one he has taken at home for 9 years). All this change in his reaction to his medication has caused him excessive stress even though he now very seldom freezes up and is doing well in therapy. His pain is nearly gone but his mind is severely playing tricks on him. I have contact his doctor at UW Madison but she has not returned my calls and e-mails for 10 days. It is looking hopeless for him to ever return home and everyday he is getting more severe reactions to his meds with spells of crying, hasn t slept for six nights, has spells of agitation and trys to exit the facility. Not sure where to go from here.
Mon, 29 Oct 2018
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Neurologist 's  Response
Hello,

Though it is possible and even likely that medications are playing a role in his mental status changes and confusion I would be concerned for an underlying organic basis for his confusional states.

Even if he really wasn't exhibiting anything significant in your mind until the fall.

Also keep in mind that sometimes the trauma from something like a fall followed by hospitalizations and changes in familiar environments combined with medications that could be adding to the mix will UNMASK an underlying cognitive disorder.

Therefore, if not already done he should be worked up with tests such as Vitamin B12 levels in serum, Thyroid hormones such as TSH and FT4, ESR and CRP in case there may be an underlying or occult infection somewhere in the body that has not been detected.

DEFINITELY, a URINALYSIS should also be done since this test detects of the most common sources of mental status changes in the elderly, URINARY TRACT INFECTIONS.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Dariush Saghafi, Neurologist
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Can Adverse Reactions To Changed Parkinson’s Medication After A Fall Be Treated?

Hello, Though it is possible and even likely that medications are playing a role in his mental status changes and confusion I would be concerned for an underlying organic basis for his confusional states. Even if he really wasn t exhibiting anything significant in your mind until the fall. Also keep in mind that sometimes the trauma from something like a fall followed by hospitalizations and changes in familiar environments combined with medications that could be adding to the mix will UNMASK an underlying cognitive disorder. Therefore, if not already done he should be worked up with tests such as Vitamin B12 levels in serum, Thyroid hormones such as TSH and FT4, ESR and CRP in case there may be an underlying or occult infection somewhere in the body that has not been detected. DEFINITELY, a URINALYSIS should also be done since this test detects of the most common sources of mental status changes in the elderly, URINARY TRACT INFECTIONS. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dariush Saghafi, Neurologist