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My aunt is 66 years old. She has had Parkinson's since 2007 and has been taking medications regularly (gradually increasing) with physiotherapy and daily walks. Her Parkinsons was getting noticeable, especially in last couple of years but she had decent health, walked regularly and was reasonably mobile, involved in minor household work. Basically, she was doing ok about a month back, fell ill after heat wave during which she had fasted for 5 days (though she remains within the house). Tremors, sleep, constipation/upset stomach were all a huge issue till few weeks back but all are much better. Can even walk a bit in the morning. But still very weak as the day goes by. But if only could lessen her weakness, she could be almost back to normal. I want to know what basically happened (was it the effects of heat wave or something else) and how to make her better on below issues? As she wakes up in the morning, she is ok. As the day goes by, she continues to get weak and by afternoon/evening, can barely more on her own and has to be helped in movements of moving on the bed. Is this normal? 1. I think it has to do with some of the activities that she does during the day. She takes a lot of time and energy to urinate and clear bowels. It takes at least 15-30 minutes each time and she comes out exhausted. She keeps feeling as if some more is left due to which she continues. When she comes out she is exhausted. Why is this happening and what medicines or massage etc to manage this. 2. When she eats, she has difficulty breathing for some time, then she is ok. How to manage this or what medicine for this? 3. She has had fever for a few weeks now. Is it because of weakness or parkinsons? How to manage this? 4. She has restless legs, due to which we have to put a lot of pillows and weight on her body to soothe her. Any way to manage or treat this? Medicines and illness history for last month A month back doctor asked her to take another tablet Stalevo in place of Sinemet but it didn't suit her. So she discontinued it after 2 days since tremors due to this had increased significantly. Then she reverted to Sinemet-plus 3 tablets every 8 hours on doctor's advice. While tremors improved, it increased weakness which is still persisting. She was already taking Requip 2mg, 3 times a day along with Jumex 5 mg 2 times daily. Doctor has now increased its does by 0.5 mg twice over last 2 weeks. Since she has blood pressure, she was taking cotasme 40/12.5mg once a day. Taking Lexotanil for sleep at night.
Dr. Okun posted a topic in Ask The DoctorDear forum members, A number of years ago it was reported that GPi DBS and pallidotomy could both help RLS in Dystonia and Parkinson's disease respectively. This group proposes the GPi as a potential target for RLS in PD. Also remember that after STN DBS for PD, RLS may emerge as a result of over-aggressive dopaminergic medication reduction. Sleep Med. 2012 Sep 17. pii: S1389-9457(12)00261-4. doi: 10.1016/j.sleep.2012.06.007. [Epub ahead of print] Globus pallidus deep brain stimulation for refractory idiopathic restless legs syndrome. Ondo WG, Jankovic J, Simpson R, Jimenez-Shahed J. Source Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, United States. Electronic address: William.Ondo@uth.tmc.edu. Abstract OBJECTIVE: The neuroanatomic substrate of restless legs syndrome (RLS) is unknown. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) and other targets is used to treat Parkinson's disease (PD), and RLS symptoms associated with PD have been reported to improve when GPi DBS is used in that population. We wish to test whether GPi DBS can improve idiopathic RLS. METHOD: We implanted bilateral GPi DBS in a subject with refractory idiopathic RLS. RESULTS: The GPi cells recordings were dissimilar to those of PD. Clinically, the patient had a good, but far from complete, response, which more prominently affected the urge to move and involuntary movements than the painful component. CONCLUSION: DBS for RLS remains investigational. Copyright © 2012. Published by Elsevier B.V. PMID: 22995627 [PubMed - as supplied by publisher] LinkOut - more resources