Expert: Mary Gordon - 11/25/2009

Question
Dear Mary,

I wonder if you can help me understand what's going on with my father... He is 81 yrs old and had surgeries on both eyes for cataract.  After his surgery 5 yrs ago, his eyesight became normal and he no longer wears his glasses.  But this past month, Oct 2009, he complained of blurred vision and slowly his vision deteriorated and now he can hardly see.  We went to an opthalmologist and the doctor said there is nothing wrong with his eyes, so we went to a neurologist and undergone a CT scan.  the result of the scan was, 'T/C multiple cerebral infarction. Impression: questionable for brainstem infarc left, cortical atrophy.  Faint hypodensity is noted in the left side of the midbrain.  Ventricles are slightly dilated with proportionate widening of the cortical sulci and cisterns.  Midline structures are in place.  Posterior fossa is unremarkable...
What's this all mean? The doctor said my father did not have a stroke as we initially suspected.  He has difficulty walking and often loses his balance.  He also has halucinations, often speaking to people who aren't there.. He often wakes up around 2 am and 3am and can't sleep anymore.. I surfed the internet so I can find answers and I read about PCA, posterior cortical atrophy , I wonder if this is what afflicts my father..The change was so sudden, is this normal? Pls help..

Thank you very much..
Melanie


Answer
Hi Melanie,

It does sound a lot like PCA - also called Benson's syndrome. Here is a good page from England that lays it out
http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200137&d...
And another
http://www.orpha.net/data/patho/Pro/en/PosteriorCorticalAtrophy-FRenPro10748.pdf

I would ask for a meeting with the neurologist to discuss prognosis and diagnosis. If he or she is not a specialist in dementias, ask for a referral to someone who is. Many locations have dedicated "memory clinics"- if there is one you can access, I would recommend going there.
http://alzheimersolutions.stores.yahoo.net/rescen.html

It sounds like this is a progressive illness - quite often the underlying pathology is Alzheimer's Disease or Lewy Body Dementia - and you need to be prepared for what comes next. You will need ongoing supports and advice as things change.

And yes, as horrible as it seems, sometimes these things can move fast - or rather, be brewing quietly for a long time before really breaking through and becoming overly obvious.

Hope this helps

Mary