Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive gait instability, frequent falls, and symptoms of cerebellar dysfunction. Reports slurred speech (dysarthria), dysphagia, and autonomic dysfunction including orthostatic dizziness, urinary urgency/incontinence, and erectile dysfunction. Symptoms are progressive and refractory to standard dopaminergic therapy.
Clinical Examination Findings
Vitals: Orthostatic hypotension noted (drop in SBP >20 mmHg or DBP >10 mmHg upon standing). General: Patient appears frail, demonstrates postural instability. Skin: Dry, reduced sweating. Cardiovascular: Tachycardia or bradycardia may be present.
Treatment Protocol
Management focuses on symptomatic relief: Midodrine or Fludrocortisone for orthostatic hypotension; compression stockings; increased fluid/salt intake. Speech therapy for dysarthria and dysphagia. Physical therapy for gait training and fall prevention. Bladder management for urinary symptoms.