Dear Dr. Joshua,?
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My uncle is residing in India, he is 67 years old and in 2001 was diagnosed with a type of myopathy in his lower back spine. He does not have pain but has lost the strengh to get up from a bed or chair. He was told that this a rare degenerative disease with no known cure. With medication and a walker he is able to get up and walk around. He is being seen by a neurologist in India who has ruled out surgery due to his age and has him on several medications for past few years.?
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CoQ (30 mg) Coenzyme 1/day?
UBiQ (100 mg) 1/day?
Beclate - 100 mg 1/day?
Serbid 1/day tablets ATP30?
Zolfres 100 mg 1/day?
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He has been on these medications for several years now and they do help somewhat in getting up and moving around slowly during the day.?
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I know you cannot make a diagnosis but is there any suggestions that you can make, maybe some new technology or new medications that may have recently surfaced that he may try. Is there any problems in continuously using these medications for years??
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Any suggestions or tests or other medications that you may advise we can pass on to his doctor to prescribe or treat or look into.?
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I have attached the following reports in the attachment:?
MRI Report?
Molecular Genetics Report?
Neuro Electro Diagnosis (2 reports)?
Histopathology report?
Lab Data?
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Appreciate your assistance and any suggestions you may have.

Dr. Joshua’s Answer

Thank you for attaching the reports as a PDF file. I have read them, and it seems he has been diagnosed with neuropathy. The reports are from 2001, including the lumbar spine MRI report which states that there is degeneration but no significant stenosis (neural compression). It seems he has been examined by proper specialists, and I’m afraid I cannot add much to the diagnosis and treatment of such neuropathy. From a neurosurgeon’s point of view, it is important to exclude lumbar spinal stenosis as the cause of claudication and weakness in the lower limbs. If an MRI shows significant spinal stenosis and the symptoms match, 67 years is not too old for a decompressive operation, although as with any surgery, there are risks. In 2001, the MRI report says no major stenosis was found, although there was compression of nerve roots on both sides in the lumbar spine at the L4-5 and L5-S1 level. Such nerve compression may cause motor weakness, especially ankle and toe movements, and sensory disturbances as well as pain.

If you feel you need to pursue this further, the only thing I, as a neurosurgeon, might suggest is to discuss with your uncle’s own doctors the possibility of having a neurosurgeon examine your uncle and look at the MRI pictures with his own eyes, and the more recent the MRI, the better. However I emphasize that I cannot say whether a new and expensive MRI is necessary and what significance it may have, and you should discuss this with the neurologist that has been treating your uncle.

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