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Mom, 73, Vascular Dementia Has progressed VERY QUICKLY (from no altered mental status to late stage 6/early stage 7 in 16 months) On my Mom’s ‘bad days’ often when she exerts herself by walking or moving, she will lose control of her muscles and will begin to spasm and tremor. She can go so far as to lose the ability to sit, sliding down a chair or off the toilet. It varies from being rigid to being dead weight. The further it goes, the less she is able to communicate or even hear what is being said to her. I believe she even passed out at one point. Her hands curl. She has been to the hospital, but they never witnessed one of the episodes, so they said it was blood pressure related. I have taken her blood pressure during and after one of these episodes and it didn’t change any more dramatically then it normally does. She has orthostatic blood pressure. Her blood pressure always drops when she stands and moves. This is NOT blood pressure. The nurses and doctors are at a loss. They have never witnessed one of these episodes and are all hesitant to make any kind of diagnosis since everything they can think of wouldn’t come and go like these do. When I take her to the doctor, it’s on a ‘good’ day, otherwise I wouldn’t be able to even get her there. From my reading, I think they are seizures. Has anyone else ever experienced anything like this? Or even have a direction for me to explore? We are looking to improve her quality of life, not necessarily treat comirbid conditions that would cause more distress than benefit since her dementia is progressing SO quickly.

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Have you considered taking a video of your mom during one of these episodes so her doctors could witness the event?
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I am just going to throw out something here, but my mom was having a few episodes the nurses called “unresponsive”. I called them fainting. When you mentioned your mom may slide from the toilet, this reminded me of these episodes. Some of these occurred while Mom was sitting on the toilet, 2 which I actually witnessed. Fine one minute, rigid, sweating, and fainting the next. The NP on her floor thought it could be due to the rather large bowel movements she was having, called it an actual condition, and put her on senacot and miralax and she hasn’t had one since. I believe this is what she diagnosed it as. The jerky abnormal movements are a symptom they mention. Hope it’s as easy as this.

www.mayoclinic.org/diseases-conditions/vasovagal-syncope/symptoms-causes/syc-20350527
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Thank you everyone.
The docs say not Parkinson’s due to the specific of the conditions surrounding the episodes.
While in the hospital for 3 days, she wore a halter monitor and no cardiac episodes of any sort were noted. She was wearing it bc her heart rate was low.
I can’t put Mom through another MRI, she would never be able to hold still that long, and I have a feeling that anything that it would diagnose wouldn’t be something we would choose to treat.
I am not good without answers. I would want to know exactly what is killing me, even if nothing could be done. That is not her personality, so I am not putting her through more testing than absolutely necessary.
Like I said before, it is quality of life. If this is something that could be abated, if not eliminated, we can pursue it with everything we have. Otherwise, we will deal with the episodes with palliative care.
This is a life journey no one should have to take.
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A couple of years ago, my mom was having episodes of altered mental status. She was admitted for a three day EEG. Seemed like a fine idea at the time except mom totally lost it and decided she was being held against her will by criminal psychiatrists. She was channelling an episode of Monk.

I do believe that it was at that hospital visit that we were introduced to the head of geriatrics. He said to us "If you're not going to do the treatment, then don't do the test". 

It's such a good way of looking at things.
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I know that early onset Alzheimer's progresses rapidly but the changes in VaDementia are generally described as step wise because there can be sudden declines with new vascular events followed by plateaus. One would hope that such a rabid, dramatic decline in someone relatively young would have had doctors searching very hard for the cause but we have all heard of instances where someone was misdiagnosed, is your mom still under the care of a neurologist? Has she had an MRI recently? What about trying a holter monitor to record heart function?
(sorry, I'm no expert and am just tossing out ideas... you must be at wits end)
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Google "syncope".

This sounds suspiciously like something cardiac related, but I'm not sure it's worth it to do a work up in her current state of advanced dementia. Was brain imaging done to rule out Normal Pressure Hydrocephalus? Is her care managed by a geriatrics specialist?
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Vascular disease can cause parkinsonism, but the transient nature of these events makes me suspect something else is going on. Has she had brain imaging done to get a specific diagnosis?
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Have the medical people specifically ruled out Parkinson's?
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Additionally, she often vomits at the end of these episodes. Also, she returns to baseline and can even improve throughout the day after one of these episodes.
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