OPCA-MSA patient

[Guest guest]

I am seeking advice on a case.

 

I recently took on a patient, female age 58, with a rare degenerative

brain disease called Olivopontocerebellar Atrophy - Multisystem Atrophy

or OPCA-MSA. Her recent MRIs show a shrinking of her brain cells (not

a loss of cells, but an actual cellular atrophy). Her main symptom is

ataxia (loss of the ability to coordinate movements and weakness).

This has been getting progressively worse over the last 5 years. She

also suffers from orthostatic hypotension, but this is less problematic

for her. She is not on any medications a this time as western medicine

has no treatment for this and no idea what may have caused this.

Mentally, she is 'all there' and does not suffer any dementia, although

this is like to develop as the disease progresses. She is otherwise

healthy with no significant illnesses or trauma in her history. At

this point, she needs help getting up and walking. She is struggling to

remain as independent as possible for as long as possible.

 

TCM examination revealed the following;

 

CC - major problems with muscle weakness and coordination. Her legs

tend to collapse from under her when she walks. She has difficulty

coordinating any movement and has difficulty physically forming words

to speak. She does not tend to have tremors, but does have some

localized shaking when trying to move a body part. Her thinking is

fairly clear, but she feels like her senses are behind a veil. She is

frustrated with the prospect of losing independent mobility and with

her increasing difficulty with communication.

 

Pulses: Generally thin and wiry and disappear when pressed. Her right

cun (Lung) pulse was noticeably stronger and more superficial than the

rest. Chi (Kidney, both sides) pulses were thready. Rate was within

normal limits. BP 118/72.

 

Tongue: dark pink (slightly reddish) with no coat and some small

horizontal cracks. Sublingual veins were dark, but not distended.

 

General observation - sitting quietly, you'd never know there was

anything wrong with her. Her color is good and her eyes bright. She

has a very slight malar flush.

 

Pain - constant, slight, dull frontal headache pain. She also says she

bruises easily and that she falls down often d/t the muscle weakness

and lack of coordination.

 

Sleep - mild insomnia with trouble falling asleep and returning to

sleep after waking.

 

BM / urination - daily normal stool. Urine is normal color and volume

but she has some urgency and frequency (particularly problematic with

her mobility issues). Nocturia 3 - 4 times per night.

 

Digestion - " feels full " all the time and burps after eating or

drinking anything. No abdominal tenderness.

 

Menopause - stopped menstruating 5 years ago (coincided with the onset

of OPCA-MSA symptoms) and has had hot flashes and night sweats 3 - 4

times per day and 3 times per night since. Otherwise she tends to feel

cold.

 

Diet - generally quite good and includes a variety of healthy foods.

 

I have only seen her once so far (initial intake and treatment). I

diagnosed Kidney Yin, Qi and Jing deficiency along with a deficiency of

Marrow. As a start, I did a very gentle 4 needle technique treatment

to tonify Kidney and gave her a mushroom tonic tincture (ganoderma

mushroom/ling zhi; astragalus/huang qi; cordyseps/dong chong xia cao;

poria/fu ling; siberian ginseng/ci wu jia; licorice/gan cao) with

instructions to mix it with hot water to drive off the alcohol.

 

I'd like to treat her symptoms more aggressively with both acupuncture

and herbs in order to provide her with some relief from the ataxia

(loss of coordination and weakness).

Any suggestions on this case would be most welcome.

 

-jude

--

Judith Saxe, Licensed Acupuncturist

Qing Ting Acupuncture LLC

Denver, Colorado

(303) 964-1996

http://www.QingTingAcupuncture.com