Multiple System Atrophy – Jose shares his story

Posted on October 25, 2012. Filed under: Uncategorized | Tags: , , , , , , , , |

Multiple System Atrophy

Jose has Multiple System Atrophy (MSA), a rare neurological disorder that impairs the autonomic (involuntary) nervous system. Patients with MSA often exhibit ataxia or poor coordination and difficulty walking. MSA shares many symptoms with Parkinson’s Disease, such as rigidity and tremor, but patients experience more widespread damage to their nervous system. Additional symptoms include changes in and/or inability to make facial expressions, dizziness, loss of fine motor skills and balance, loss of the ability to sweat, gait changes, posture difficulties, tremors, voice and vision changes.

Physicians often make a diagnosis based on a patient’s history of symptoms, physical examinations, and ruling out of alternate causes. There is no cure for MSA, and no known way of preventing the progression of the disease in general. The goal of treatment is to manage and control symptoms.

Treatment includes prescription drugs aimed at specific symptoms such as low blood pressure and tremors, and in some cases a pacemaker may be used to regulate a patients heart rate. Physical therapy is an essential part of MSA treatment as well to help patients maintain their mobility and to prevent contractures, falls, and to ensure the patient’s general safety.

When I met Jose he was walking with very small step length…2 inches with a walker. He was going to pain doctors for his neck and back. After testing his balance reactions we placed 1.5 pounds in his BalanceWear orthotic. Immediately his step length increased to 4-5 inch steps. I know that isn’t much but it doubled what he was able to do on the same day. I didn’t see him for a month. When I did his pain in the low back was gone. He is now walking with a cane or without one. He is able to perform many more activities of daily living.

It is not about just changing symptoms. It is about applying interventions that improve mobility, balance and confidence. He still needs therapy to address his neck, improve his stability, endurance and walking.

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SpinoCerebellar ataxia

Posted on July 23, 2012. Filed under: Cerebellar ataxia | Tags: , , , , |

There are many forms of SpinoCerebellar Ataxia: We are going to discuss the following three cases with SCA6.
Spinocerebellar ataxia type 6 (SCA6) is a late onset rare autosomal dominant disorder characterized by peripheral neurapathy (loss of sensation to the feet), poor control of the trunk, wide based gait and uncoordinated walking. Patients will often exhibit oculomotor (eye movement) disorders, dysarthria (poorly articulated speech) and incontinence. The cerebellar degeneration is said to be progressive and permanent.
Prior to being diagnosed, patients may report wooziness, slight imbalance when turning corners, and note lack of coordination, dizziness. The age the disorder typically develops is between 43-52years however this can vary from 19-71years. Other signs of SCA6 are nystagmus (uncontrolled eye movement) and loss of vibratory sense.
I recently saw three women with SCA6 and had good results with Balance-Based Torso-Weighting (BBTW). Today I will write about Rolynn and our first visit…I saw her twice.
I saw Rolynn for the first time in June 5, 2012. She is the youngest and the most able of the three. Rolynn was able to walk without any assistive devices. She complained of difficulty walking. “I feel like I am on a trampoline. If I could just carry a cup of coffee without spilling I would be happy. One of the first things I noticed with this disorder is that when I would lie back on the bed I would feel so dizzy.” She demonstrated how she had to lay down. She would lay on her side with her arm supporting her head, she stayed in that position for a few moments. Then she would let her head down on the bed while she was on her side and rest for a few more seconds. The she would roll the bottom half of her body on to her back wait and then bring her head around. That was the only way she could lay on her back without dizziness. The other major symptom was inability to touch her heel to her shin in a coordination test. She had jerkiness when she first stood up (loss of balance) and often could not stand and just start walking.
After applying BalanceWear on the same day, Rolynn was able to lay down without having to perform the procedure mentioned above. Videos were taken and she didn’t have the downbeat nystagmus (Meaning the eye beats downward) as much while wearing BalanceWear.. Her heel-shin coordination test improved so that she could touch her shin yet it was still jerky but she could get the heel to the shin now…on the same day! Her ability to get up from sitting and stand and walk improved as well as her walking. When I arrived to check her out the next day….To be continued stay tuned


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