Department of Neurology
Administration Nursing Team Secretaries
Conquest: Specialist Nursing Secretary
NHS Number: xxx xxx xxxx
Clinic Date: 04/10/2024
GP Code:
Mr. Steve2
Adress.
To whom it may concern;
Dear Sir/Madam,
Mr. Steve2 DOB: 1954
I have been asked by this gentleman to send a referral for him to be seen privately by a Neurologist, for investigations into his Distal Sensory Axonal Large Fibre Neuropathy. He has an atypical Parkinsonism that greatly affects his mobility, and he has suffered for several years with discomfort in his feet, legs and spine.
He was initially seen by Dr. Hova Garabedyan, Consultant Neurologist, in May of 2023, who describes a presentation of a wide-based shuffling gait and difficulty initiating movement, with rigidity in the left leg and postural and intention tremors, which were worse in the left arm.
He has symmetrical deep tendon reflexes with flexor plantars. Hova’s belief was a combination of degenerative lumbar radiculopathy and gait ataxia with apraxia, with a possible degenerative cause, leading to him organising an MRI of head and spine, as well as a Dopamine Transporter Scan. The Dopamine Transporter Scan was abnormal and supportive of a diagnosis of Idiopathic Parkinson’s Disease or Parkinsonian Syndrome.
The MRI scan showed only minor degenerative
changes, with no evidence of cord compression or signal change. There was foraminal stenosis on the left, with likely compression of exiting left C4, C5 and possibly C6 nerve roots. He is currently prescribed Sinemet 62.5mg x 2 TDS for his Parkinson’s, as well as Apixaban 5mg twice a day, Bisoprolol 2.5mg daily and Amitriptyline 20mg at night. He is also taking Mirabegron 50mg modified release daily for his urinary urgency and Quetiapine as he is very prone to nightmares.
As there is something of a severe backlog locally in seeing a local Neurologist for assessment, I think it would be very beneficial for him to be seen privately via Benenden Health.
Hope some find the above interest.
Does anyone have any opinions on what is wrong with me in layman’s terms.
Not sure about everyone else but I find it all quite difficult to understand.
Best wishes
Steve2