[Akash]

Hi all, my father who is 80+ years old based out of India,was diagnosed with PD some 5 years back.

He was doing ok on Pacitane (https://en.wikipedia.org/wiki/Trihexyphenidyl) but suffered some amount of memory loss and cognitive impairment which was improved by B vitamin injections. However, a PD specialist had him shift to Syndopa (Synthetic Dopamine) after Carbidopa/Levidopa were tried first as I recall - as he felt it was a better treatment. None of these worked. Literally within months my fathers condition worsened. He developed dyskinesia, started having an inability to move, began shuffling.

However, for lack of a better alternative he stuck to Syndopa and now his symptoms have worsened significantly, while on Pacitane he was able to move around and had very little tremors, dystonia, drooling, on Syndopa the PD has progressed significantly with all the latter making his Quality of life miserable. Due to advanced age, DBS is not possible.

We recently went to another doctor whose conclusion is my father has some sort of Parkinson's Plus issue going on. Not Parkinsons alone as it would have been helped by Syndopa and analogs.

My question is are there any valid treatment methodologies for Parkinsons Plus or any possible things that could be affecting somebody apart from Parkinsons which are adjuncts to the overall issue. My father did have a love for a good drink, rich, sweet food and many years back he had to have his gallblader removed for the same. He was ok thereafter and he was however very physically active, going on long brisk walks & physically quite strong, self sufficient, mentally alert (post his engineering job and retirement, he remained very active and used to drive long distances too). Just adding this as a possible useful point regarding activities of daily living etc. His brain MRIs came out "normal" in that they merely show age related vascular changes but nothing particularly striking.

I was wondering whether it is common for a drug shift to cause such issues (Pacitane to Syndopa) and whether that provides a clue. Or it was merely progression and whether his severe movement issues (inability to take steps/stopping/motor control issues; drooling; drooped eye palsy on one side) are in fact Parkinsonian alone or are they a side effect of the Dopamine.

Can any B-Vitamin supplementation help?

He is mentally very alert and sharp. Its his motor control which is a severe issue for him, apart from his drooling which we have been recommended Botox for. However, his motor control issues have had no ideas suggested.

Any ideas, tips would be very welcome.

[TexasTom]

Akesh,

Not much to add. The Syndopa and other medication I have not heard of.

Ayurcedic medicine called for tummeric and black pepper. Still a good combination.

One cognitive issues, my mind was wondering more than I wished. I do have some issue recalling words and location, but when I had a full blood panel done it was obvious I was lacking Vitamin D. So I am taking 4000IU daily, and it seems to help (I'm still working -- Electronic Engineer; Oh company CEO is a well known native of India, and does his daily Yoga excercises).

Where in India is your father located?

[Aunt Bean]

If he doesn't have Favism...which can be detected with a G6pd blood test....try fava beans. Also adding papaya to his daily diet (if he isn't latex sensitive) Egg plant/ peppers/ tomatoes ...green and ripe all have nicotine in them which seem to really support us well if he isn't allergic to these. Watermelons/ strawberries/ blueberries all are supportive also. Exercise and sunshine. Vit B complex supplements/ vit D 3 and 6/ coQ 10/ eggs or lecithin/ and a memory support of some kind...there are many on the market to support brain health. l-carnitine and l-carnosine both help.

[rempatterson]

Parkinson Plus Syndromes comprise a set of things that are atypical but look like PD. They include Progressive Supranuclear Palsy, CorticoBasal Degeneration, and Multiple System Atrophy. They have different treatments and need to be addressed in different ways from the ways we normally address PD itself. I suggest searching credible websites for "atypical parkinsonism," "parkinson plus syndromes," etc.