International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy

A 66-year-old male patient had a history of hepatitis B, was a hepatitis C carrier, and had hypertension. He was referred to our family medicine international clinic by the Canadian Physician's Referral Service. He had had progressive general weakness over 2 years, and the symptom had recently...

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Main Authors: Ying-Hua Shieh, Kuong-Hang Fong, Shiou-Dar Su
Format: Article
Language:English
Published: Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) 2009-09-01
Series:International Journal of Gerontology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S187395980970047X
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author Ying-Hua Shieh
Kuong-Hang Fong
Shiou-Dar Su
author_facet Ying-Hua Shieh
Kuong-Hang Fong
Shiou-Dar Su
author_sort Ying-Hua Shieh
collection DOAJ
description A 66-year-old male patient had a history of hepatitis B, was a hepatitis C carrier, and had hypertension. He was referred to our family medicine international clinic by the Canadian Physician's Referral Service. He had had progressive general weakness over 2 years, and the symptom had recently exacerbated. He also had slurred speech, difficulty in swallowing with occasional choking, constipation, and urinary incontinence. He was diagnosed as having Parkinson disease, but his symptoms worsened despite treatment with levodopa 250mg four times daily for 2 years. He had sought medical help in many clinics in Taiwan and Canada and was referred to our outpatient clinic by his Canadian family physician. The neurologist suggested that the diagnosis was multiple system atrophy (MSA) after history taking and neurologic examination. Rehabilitation programs, including physical therapy, occupational therapy and speech therapy, were arranged for him. Many Taiwanese immigrants prefer to come back to Taiwan for medical treatment. If we can integrate medical resources not only between different hospitals but also between different countries, many unnecessary medical expenses could be avoided. In this case, we summarized the case history and provided him with a CD of the images. This will be helpful in further care by a Canadian physician.
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spelling doaj.art-7f9ff375cca944048bfff63088919bfa2022-12-21T23:49:56ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982009-09-013319219410.1016/S1873-9598(09)70047-XInternational Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar AtrophyYing-Hua ShiehKuong-Hang FongShiou-Dar SuA 66-year-old male patient had a history of hepatitis B, was a hepatitis C carrier, and had hypertension. He was referred to our family medicine international clinic by the Canadian Physician's Referral Service. He had had progressive general weakness over 2 years, and the symptom had recently exacerbated. He also had slurred speech, difficulty in swallowing with occasional choking, constipation, and urinary incontinence. He was diagnosed as having Parkinson disease, but his symptoms worsened despite treatment with levodopa 250mg four times daily for 2 years. He had sought medical help in many clinics in Taiwan and Canada and was referred to our outpatient clinic by his Canadian family physician. The neurologist suggested that the diagnosis was multiple system atrophy (MSA) after history taking and neurologic examination. Rehabilitation programs, including physical therapy, occupational therapy and speech therapy, were arranged for him. Many Taiwanese immigrants prefer to come back to Taiwan for medical treatment. If we can integrate medical resources not only between different hospitals but also between different countries, many unnecessary medical expenses could be avoided. In this case, we summarized the case history and provided him with a CD of the images. This will be helpful in further care by a Canadian physician.http://www.sciencedirect.com/science/article/pii/S187395980970047Xmultiple system atrophyparkinsonismreferral
spellingShingle Ying-Hua Shieh
Kuong-Hang Fong
Shiou-Dar Su
International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
International Journal of Gerontology
multiple system atrophy
parkinsonism
referral
title International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
title_full International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
title_fullStr International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
title_full_unstemmed International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
title_short International Referral and Elderly Care—A Case of Atypical Parkinsonism and Cerebellar Atrophy
title_sort international referral and elderly care a case of atypical parkinsonism and cerebellar atrophy
topic multiple system atrophy
parkinsonism
referral
url http://www.sciencedirect.com/science/article/pii/S187395980970047X
work_keys_str_mv AT yinghuashieh internationalreferralandelderlycareacaseofatypicalparkinsonismandcerebellaratrophy
AT kuonghangfong internationalreferralandelderlycareacaseofatypicalparkinsonismandcerebellaratrophy
AT shioudarsu internationalreferralandelderlycareacaseofatypicalparkinsonismandcerebellaratrophy