Question: I am 80 years old and was diagnosed with Parkinson’s disease in 2017. I have also suffered from atrial fibrillation, have had breast cancer surgery and have osteoporosis. The main concern now is my Parkinson’s. I have had an MRI scan of my brain. Answer: Slight reduction in volume relative to the patient’s age. A spinal tap has been carried out. Answer: The examination shows no signs of NPH. My main problems are fatigue, incontinence and extremely sluggish bowel movements. I am forced to take laxatives. What help is available? I take 1.5 Madopark tablets, 5 times a day, plus one Madopar Depot tablet at 10.00 pm. When I Google NPH, my symptoms seem to match quite closely with what is described there. Could it still be NPH, or is there another cause?
I have no pain or tremors and my sleep is so-so.
Answer: An MRI scan of the brain is a good way to rule out NPH (normal-pressure hydrocephalus), so you probably don’t have it. The symptoms of Parkinson’s can sometimes resemble those of NPH. Constipation is a typical symptom of Parkinson’s. You could try increasing the fibre content in your diet, but if you do, you’ll also need to drink plenty of fluids – ideally 2 litres a day. This might be problematic, given that you mention incontinence, but try drinking more during the first few hours of the day. There are also laxatives that your doctor can prescribe.
Dag Nyholm