Expert: Paula Damgaard - 4/5/2010

Question
QUESTION: Hi, My mom has been diagnosed with small vessel disease over a year ago. She suffers short term memory loss. Recently we put her in a very loving foster care type home. We really appreciate the loving cars she gets there.
last week her blood pressure went to 225. She was very calm, talking and seemed totally fine, the caregivers were nervous,(of course so were we) so we took her to emergency. It took them a long time and several meds to get it down, finally it did, after 3 days it came down. the doc suggeted physical therapy since her walking seemed a like she was slowing down. He also gave her an additional blood pressure med, Toprol. She was already on lisinopril, 10 mg. Now yesterday, she could barely walk, after awile, she started using a walker. We gave her gatorade and a bananna, I was thinking maybe these meds made her have problems with her electrolytes? Could these drugs do this to her?
thanks!
Love my Mom!

ANSWER: Hi Anne,

From what I have read, I don't see that any of these drugs would cause her walking to be affected.  Having said that, everyone is different and she may have a reaction that is not gold standard.  Or she could have had more of a stroke or TIA, which is what caused her small vessel disease to begin with.  The drugs can cause a problem with electrolytes, but this shouldn't affect her walking either. It is more like muscle cramping.  

Have they done a repeat head scan?  Either an MRI or a CAT scan?  This would answer those questions.  Having a blood pressure that high could be cause for a stroke or TIA.  TIA is transient ischemic attack, which is a small stroke that can happen unbeknownst to the person, or if it is noticed it resolves very quickly.  

I would check with her doctor and ask these questions.  Hope you find the answer.  Paula

---------- FOLLOW-UP ----------

QUESTION: she just started on nemeda, and we took her off last week, her walking is fine now, could it have been that?

Answer
Hi Anne, unfortunately there is no real answer.  Sure it could have been her reaction, not a known one, again.  Or she could have had a TIA which resolved.  Which would return her to her baseline.  

Only real way to find out is to retry Namenda.  Not sure id you want to go that route or not.  It is not easy to find answers to patients with these illnesses cause they can't really help us answer them.  Also you don't know for sure if she just has small vessel disease or if there is some Alzheimer's in there as well.  No one can give you a 100% diagnosis till autopsy.  

If you haven't asked about that then I would do it now.  That information could be extremely important to you later on.  If you find out what diagnosis she has and they are looking for people who have a first degree relative who had it, you could take part.  Right now you have a diagnosis of probably.  Check with her doctor about who does them and where.  It will be the biggest gift your mom could ever give you.  

Paula