An Uncommon Cause of Recurrent Falls in the Elderly

Caleb Fisher- 0158698

08/16/11

DIAG-3755

An Uncommon Cause of Recurrent Falls in the Elderly

When assessing the elderly population you will find that falls are a common report in taking the patient’s history with about five percent leading to serious injuries like hip fractures foe example. Examinations for the cause of falls are usually mundane, but can be challenging to the doctor with surprises in diagnoses. The examinations should consist of assessment of intrinsic and extrinsic risk factors. Without careful assessment of the intrinsic factors (gait, balance issues, cognitive, and sensory issues) or extrinsic factors (poor lighting, slippery floors, or inappropriate use of walking aids) clinician can overlook these falls as symptoms of Parkinson’s Disease. In this report a previously active and healthy elderly man presented with repeated falls and rapidly progressive limitations in mobility coupled with stutter. Neurological imaging was helpful for making the proper diagnosis in this particular patient. Patient was diagnosed as to have Parkinson’s Disease, but further deeper examination revealed that patient was actually demonstrating Parkinson’s like symptoms. The course of fifteen months patient had gone from an active 73 year old to being unable to perform majority of his activities of daily living without assistant from his wife. In December of 2009 patient had received his first CT scan of brain which was only reported by having no skull fractures or subdural hematoma. When patient was referred to a Geriatric Clinic in January of 2010, the same Dec 2009 CT scan was reviewed and showed to have left frontal lobe atrophy, particularly in the posterior frontal region. After further analysis of the patient’s current symptoms the tentative diagnosis was changed to Primary Progressive Aphasia (PPA). A brain perfusion further rendered that the patient had asymmetrical frontal lone atrophy. In conclusion Parkinson’s Disease symptoms...