Ladies and Gentlemen,
My father had a brain surgery 3.5 years ago in order to remove a tumor. As the operation was carried out near a region that controls the left hand and feet, the surgeon warned him that he may have motor control issues with, especially, his left foot. But if such issues should occur, they would most likely resolve naturally in 3-4 months. For over 2 years, no problems with feet or hands surfaced. Then after 2+ years, he began having serious issues controlling his left foot. After many visits to brain and neural specialists and following physical therapy, he saw little improvement. The issue is that the foot is weak and hard to control. He cannot place the foot exactly where he wants, which causes problems when passing through hallways and the like; he often hits his foot on nearby objects and walks with little control or stability. It is very tiring for him to walk. More importantly, the foot will freeze after a few minutes of walking. It becomes impossible to move until he rests for a while.
Recently, two new doctors diagnosed the condition as Parkinson's - how in the world it took so long to diagnose the illness correctly is a mystery to me. The issues were traced back to dopamine deficiencies in the brain and he was put on 3 medicines. One is a dopamine agonist (Pexola, i.e. Pramipexol) the other is modafinil, which he takes when he has to drive because the first drug causes excessive sleepiness. The last drug is an MAO-B inhibitor. I do not have the exact name of this drug but when I saw the package, I confirmed that it was NOT selegeline (as an aside, i have no idea why this last drug is so expensive. Selegeline is pretty cheap as far as I know).
Unfortunately the drugs didn't improve the situation at all (he is 62 yrs old and has been on these medicines for close to 3 months now). I was wondering what everyone's opinion on this may be. Also, allow me to ignorantly speculate here: The "freezing of the foot" which he experiences is extremely similar to what happens to me after a heavy quad/calf workout (in his case, on a larger scale, of course). As he is standing, the foot and numerous other muscles below the knee will uncontrollably twitch. He has to wait a few minutes before he can move the shin/foot again. Is this not what happens when you locally run out of AcetylCholine? The impulses sent by the brain to move the muscle can no longer be executed because the messenger AChl is depleted? Also, would dopamine deficiency not cause other issues in addition to a very local muscle control problem? I have talked to him onthe phone today and his mental sharpness is as great as ever, he is very witty and quick. How can that be if he is having dopamine deficiency in the brain? Is it possiblt to have a dopamine problem in only a very limited are of the brain -i.e the part that controls the left foot- and nowhere else? Again, sorry if this is way off and ignorant...
Any input would be greatly appreciated.
Thanks
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