Treatment of corticobasal degeneration

There's currently no cure forcorticobasal degeneration (CBD) and no treatment to slow it down, but there are lots of things that can be done to help manage the symptoms.

Carewill be provided by a team of health and social care professionals working together. This is known as a multidisciplinary team.

Members of yourmultidisciplinary team may include:

  • a neurologist a specialist in conditions that affect the brain and nerves
  • a physiotherapist whocan help withmovement and balance difficulties
  • a speech and language therapist who can help with speech or swallowing problems
  • an occupational therapist who can help you improve the skills you need for daily activities at home, such as washing, dressing, or getting around
  • a social worker who can advise you about the supportavailable from social services
  • a specialist neurology nurse who may act as your point of contact with the rest of the team
  • special care advisors from the PSP Association

A care plan will be drawn up in discussion with your team. This will outline the treatments you need to help with the symptoms of CBD , as well as the support and advice you require to make your life easier.

Medication

There are currently no medications that treat CBD specifically. Depending on the person's symptoms or complications, the following may be used:

  • Muscle stiffness of contractions levodopa, amantadine, clonazepam, baclofen, gabapentin, or botulinum toxin injections to relax the muscles.
  • Jerky movements clonazepam or levetiracetam
  • Memory and related mental abilities the medications used to treat Alzheimer's disease may also be used in CBD, such as donepezil or memantine.
  • Irritability or depression medicines such as citalopram or trazodone.
  • Sleep problems short term use of temazepam, zopiclone, melatonin or others medicines
  • Bladder problems and incontinence medicines to relax the bladder, or help it empty more regularly may be needed, such as oxybutynin or miabegron
  • Pain and anxiety simple painkillers like ibuprofen, and more specialist medicines like gabapentin
  • Bone strength if people are prone to regular falling, osteoporosis (weak bones) and vitamin D problems should be ruled out or treated

In general, people with CBD are sensitive to medication side effects. Doses may start low and be increased gradually.

Some medications should be avoided completely, such as haloperidol (a medicine used to treat some mental health problems).

Cognitive stimulation

Cognitive stimulation is a type of therapy used to treat dementia, and it may be helpful if a person with CBD has dementia symptoms.

It involves taking part in activities and exercises designed to improve your memory, problem-solving skills and language ability.

Regular exercise can help strengthen your muscles, improve your posture and prevent stiffening of your joints.

They can teach you breathing exercises to use when you eat, to reduce your risk of developing aspiration pneumonia (a chest infection caused by food particles falling into your lungs).

Speech and language therapy

A speech and language therapist can help assess and treat speech and swallowing problems .

They can teach people a number of techniques to help make the voice as clear as possible and can advise you about suitable communication aids or devices that the person may need as CBD progresses.

A therapist can also advise you about different swallowing techniques and, working together with a dietitian (see below), they may suggest altering the consistency of your food to make swallowing easier.

Diet and severe swallowing problems

You may be referred to a dietitian, who will advise you about making changes to your diet, such as including food and liquids that are easier to swallow, while ensuring that you have a healthy, balanced diet .

Feeding tubes may be recommended for severe swallowing problems, where the risk of malnutrition ,weight loss, fatigue and dehydration is increased. You should discuss the pros and cons of feeding tubes with your family and care team.

The decision about whether and when to consider a feeding tube depends on the individual and should be discussed with a specialist.

It can be offeredat any stageof CBD, alongside other treatments.

Palliative care can be received:

  • in a hospice
  • athome or in a residential home
  • on a day patient basisin a hospice
  • in a hospital

They share these plans with both their family and the health professionals involved in their care.

This can be useful in case you're unable to communicate your decisions later on because you're too ill. However,you don't have to do it if you don't want to.

Issues that you may want to cover include:

  • if you want to be treated at home, in a hospice or in a hospital when you reach the final stages of CBD
  • if you would be willing to use a feeding tube if you were no longer able to swallow food and liquid
  • if you'd be willing to be resuscitated if your heart were to stop

If you decide to discuss these issues, they can be written down in a number of ways:

  • Advance decision to refuse treatment
  • Advance statement
  • Emergency healthcare plan
  • Preferred place of care
  • Enduring Power of Attorney

Your care team can provide you with more information and advice about these decisions and how best to record them.

.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 28 Nov 2016