New illness mistaken as Parkinson’s disease

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DEAR DR. DONOHUE: My sister-in-law was diagnosed with Parkinson’s disease in the early 90s. She had no tremor, and the medicine didn’t address her symptoms. Three years later she was properly diagnosed with progressive supranuclear palsy – PSP. The actor Dudley Moore had it. There’s a fantastic Web site – www.psp.org – that provides lots of information.

I think the public deserves to know about this illness and doctors to consider it when people don’t respond to Parkinson’s medicine. – C.C.

ANSWER:
Progressive supranuclear palsy, PSP, is worth a mention since it is a relatively newly described illness and lacks public recognition. It has some features that make it look like Parkinson’s disease, but it also has its own unique signs and symptoms.

One early sign is an inability to turn the eyes downward, and that leads to tripping and stumbling. As time passes, the ability to move the eyes upward becomes impaired.

The “supranuclear palsy” name comes from this loss of eye movement. The supranuclear area of the brain – one of the areas affected in PSP – controls eye muscles, and “palsy” indicates weakness. People with the condition fall suddenly and without any warning. Parkinson’s signs include rigid muscles, a frozen facial expression and balance trouble. Tremor, however, is not a usual sign of PSP.

There is no cure for PSP, but the medicines used for Parkinson’s disease are also used for it. They are not as effective as they are for Parkinson’s. Occupational therapists are a godsend for people with this condition.

They are highly trained medical specialists who know how to teach people to use muscles in ways they are not accustomed to using them and can provide them with tools that make the tasks of daily living possible.

The Society for Progressive Supranuclear Palsy is a source of information and advocacy for patients and their family. In addition to the Web site you gave, people can contact the society at 800-457-4777.

DEAR DR. DONOHUE: A neighbor moved and left me with a 1-1/2-year-old Manx cat. I had him neutered. He has AIDS. He is healthy otherwise. The vet wanted to put him to sleep. I have him in my home, and he is so good.

What should I do? – V.R.

ANSWER:
We have to make it clear to people right from the start that feline (cat) AIDS is not the same as human AIDS, and humans do not get sick from a cat with this infection.

Feline AIDS, like its human counterpart, can destroy a cat’s immune system and leave it vulnerable to a host of infections. However, most cats infected with the feline AIDS virus don’t become sick until six to 10 years after they were infected.

If your cat shows no signs of infection – listlessness, weight loss, disinterest in eating, swollen lymph nodes – you don’t have to do anything. You should keep the cat indoors so he does not infect other cats.

Ask the vet his or her reason for wanting to “put him to sleep.” If it isn’t a good one, you don’t have to follow the advice.

DEAR DR. DONOHUE: My granddaughter is 10 years old. When she was 4, we were told she had a horseshoe kidney. All we were told is to watch for kidney infections. She has had ultrasounds of her kidney every two years. She is very active in sports and seems quite healthy.

Now the doctor says she doesn’t need any more ultrasounds. Should we be concerned? – D.S.

ANSWER:
A horseshoe kidney is one in which the two kidneys have fused to form one large kidney. The fusion takes place in their uppermost or lowermost sections, and the single kidney looks like a horseshoe. People function well with such a kidney.

Your granddaughter has gone 10 years without an infection. She should not run into big trouble now. She is more prone to an infection, and that has to be watched, but the ultrasounds can stop.

The pamphlet on urinary tract infections deals with kidney infections in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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