Parkinson’s unresponsive episodes.

Hello @farmerleebs and welcome to Mayo Connect. Thank you for posting your concerns about your mom in our Parkinson's discussion group. How long due the unresponsive episodes last? Several hours or less than that? When your mom went to the hospital do you recall what kind of tests she had? Was an MRI done? What about an EEG (where they put electrodes on the head to determine brain wave activity)?

How long do these unresponsive episodes last (for several hours or less than that) and how often do they occur? Has she had a work up with a movement disorder specailist? A movement disorder specialst is a neruologist who has special training in disorders like PD.

Here is a link to a website from Mayo Clinic that lists different reasons for unresponsive episodes. I would encourage you to read it.
https://www.mayoclinic.org/search/search-results?q=unresponsiveness

As you can see, others in this group have discussed unresponsivness in elderly parents who have PD. I would encourage them to share with you their findings. I would like to invite @bethv, @mshoggie and @judithanne to share with you as well.

The unresponsive episodes seem to last anywhere between an hour or two. Leaning more towards the two. I know they did a cat scan and it came up normal. They took her vitals and they were low normal. There is no specialists involved. We live in a really small town and with Covid they have only taken her to the hospital once. Thank you for your help.

@farmerleebs, I wonder if hypotension or very low blood pressure may be causing the unresponsive episodes. See this article that @judithanne references earlier in this discussion:
- Cognitive fluctuations in Parkinson’s disease dementia: blood pressure lability as an underlying mechanism https://clinicalmovementdisorders.biomedcentral.com/articles/10.1186/s40734-018-0068-4

Is it possible that her blood pressure is low, but by the time she is seen by a professional her blood pressure has recovered? Do you have a home blood pressure monitor?

Hello again @farmerleebs

I appreciate the extra information you provided about your mom's episodes. Vitals, with a low normal might indicate, as Colleen, @colleenyoung, suggested that low blood pressure and/or low heart rate might also be a factor, I would encourage you, as Collen did, to have a blood pressure monitor available and to check your mom's BP and heart rate on a regular basis. Then when and if she has nother episode, you might be able to pinpoint if her BP drops lower than what is her ususal BP. Are you aware that the meds used for Parkinson's can also cause a decrease in BP? When she next sees her primary care provider, you might ask for a testing of her BP when she is seated and then again after standing and being seated again. This will often reveal this type of fluctating BP problem.

I also have Parkinson's and fight the low BP problem brought on by the Parkinson's meds as well as meds that I take for a heart condition. Given your mom's age, I'm sure she might be taking BP meds as well. Is your mom a diabetic?

I will certainly look in to this. She is at a care home for which I go to see her, now 4 times a week because of COVID. I am going to get them to check her blood pressure more often. Thank you!

Hello @farmerleebs,

It has been a while since you posted about your mom's unresponsive episodes and I was wondering how she is doing. Has she been able to see a doctor who could look into this further?

Will you post an update?

Thank you ever so much for asking. My mom has not had another episode since then. She does have a hand, on her right, that lies in her lap a lot and does not seem to work as well as her left. She will lift it but she does not really use it at all. Luckily she is left handed. So I am not sure if it was a stroke or Her Parkinson’s. They did run a CT scan on her, before her hand went like it is, and it didn’t show anything. She is still in lockdown in her complex care home but I go in 4 mornings a week. I help her with what she needs done. Thanks again for asking.

Hi @farmerleebs,

So glad for the update and also happy to hear that your mom's episodes have not been more frequent. That is good news, I'm sure. You might consider requesting an MRI if the CT scan did not show anything. An MRI can sometimes show more detail of the brain.
It is good that you can visit and help her four mornings a week. I'm sure that she appreciates that as well.

@bethv, @chuckcallahan, @mshoggie, @judithanne

Hi All:

As you have all mentioned in the past about unresponsive episodes of friends or family members who have PD. I was looking to see if you have any updates on those folks. Do they continue to have these episodes? Have you found anything to help?

My dad is 86. He has had PD ~10yrs. He has been managed by a terrific movement disorder specialist at a University hospital. I am an PT and dad has maintained a daily walking and exercise program that has helped him maintain his mobility. The past year he has started to decline with more falls, more confusion and hallucinations. He has been on Seroquel for the past 3 months and that has helped manage his hallucinations. Dad has had 2 previous episodes of unresponsiveness in the past 6 weeks that lasted ~1-2 hrs. Today, I could not wake him up in the morning. He was unresponsive for 3 hours. His HR, BP, SaO2, blood sugar and temp were all normal. I called his MD and was told to take him to ER. As soon as I got off the phone with MD, he woke up. He doesn't remember anything. He was totally fine after he woke up. Does anyone have any other updates on why this is happening? Is it a progression of his PD? Could it be seizure activity or related to the seroquel? The doctor has suggested he start Nuplazid and eventually reduce the seroquel from his current dose of 37.5 mg. Nuplazid will take ~3months to start working. Any advice is appreciated.