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Washington University Experience | NEURODEGENERATION | Progressive Supranuclear Palsy (PSP) | 10A0 Case 10 History
Case 10 History ---- This 87yo female was first seen in the MDC at age 73. At age 59 she noticed marked reduction in olfaction. At age 67, she had reduced left arm swing. At age 69, she had trouble typing with the right hand being too slow and handwriting with the right hand became slower and smaller. By age 72, her voice became softer. By age 73, she had left hand resting tremor. That year, she felt less steady walking, particularly on uneven surfaces. By age 78-79, she developed freezing. She had mild peak dose dyskinesias and mild off-period dystonia. By age 81, she developed excessive daytime sleepiness. She had trouble with concentration and by age 82, cognitive problems increased and she was no longer able to use a computer to email or use a phone. By 83, she had sufficient cognitive impairment to diagnose dementia. By age 85, she required full care at a residential care facility. She needed help with feeding, dressing and hygiene. She progressed in the last 1-2 years of her life. She was finally put on hospice care. She had not been eating for several days and had no oral intake for at least a few days prior to death. She had a very low grade fever ~ 99 to 100°F but no other signs of infections. At the time of death, the cause of death was recorded as inanition and dehydration due to Parkinson disease.
