Have you ever had these things happen to you? When you read a newspaper, the letters seem to get tangled up, or when you see someone you know well, you suddenly can't recognize them. Or do you constantly bump into doors, tables, and chairs at home? If you can see well, but you feel something strange about the way things look, and if you feel a little scared or anxious at the same time, it is important for you to be aware of this condition we are talking about today called `(Posterior Cortical Atrophy)`.
What is Posterior Cortical Atrophy (PCA)?
Simply put, `(Posterior Cortical Atrophy)` or `(PCA)` is a progressive, and somewhat rare, disease related to our brain. We call this a `(neurodegenerative disorder).` What happens here is that the brain cells, ` (neurons),` in the posterior cortex of our brain, that is, the `(posterior cerebral cortex),` especially in the part that helps us understand and analyze what we see, are gradually destroyed. This part of the brain includes our `(parietal lobes)` and `(occipital lobes)`. Due to the destruction of these cells, that part of the brain gradually shrinks. We also call this `(atrophy) .`
The important thing is, this is not a visual impairment in the eyes. It is a problem in the process of what the eyes see going to the brain, and the brain understanding it as 'this is what I saw'. It is like taking a photo with a good camera, but when the processor of the computer that is viewing that photo malfunctions, the photo does not look right.
What are the symptoms of this?
These symptoms usually begin between the ages of 50 and 60. Early vision problems are the most common. Let's take a look at what they are.
1. Difficulty reading:
Imagine that you are reading a newspaper or a book like this. Then suddenly you may feel as if the letters are moving one above the other, the lines are jumping back and forth . Some people feel that the words and letters are stuck together and tangled. Others say, 'Oh doctor, when I try to read, it feels like the letters are sliding off the page.' This makes it difficult to understand what you are reading, and you cannot continue reading.
2. Inability to perceive distance:
This is also a problem that comes to mind for many people. For example, they may be afraid to go up or down a flight of stairs because they don't know exactly how far apart the steps are. Or, when they pull over to the curb, they can't tell the distance between the tires and the curb. Some people are also afraid to go up an escalator because they can't know when and where to step.
3. Difficulty understanding directions:
Even if you're told a simple direction like 'turn right' or 'go left', it can be difficult to understand and act on it. You suddenly feel like you can't remember which is right and which is left .
4. Inability to recognize faces, objects, and places:
This may seem a bit serious, but it can happen at first. Even if you see someone you know well, you can't immediately figure out, 'Oh... who is this?' Sometimes it takes a while to recognize something familiar, even if it's an item you already have at home. Sometimes, even the place you're in can suddenly feel strange.
5. Banging on doors and furniture:
Even though you can see clearly, you may find yourself constantly bumping into things like doorways, tables, and chairs in front of you because you can't figure out exactly where they are. You may wonder, 'Why am I bumping into everything?'
6. Difficulty working with numbers:
Imagine that you have your best friend's phone number memorized. But when you pick up the phone and try to dial the number, you can't find the digits on the phone. You can see the digits, but your brain can't seem to grasp them.
7. Difficulty using appliances and switches:
Even though you can 'see' the location of the 'on/off' switch on a household appliance like a blender or rice cooker, it can be difficult to use them because your brain can't figure out exactly where it is.
8. Anxiety without cause:
Along with these things, people with PCA may experience an unexplained feeling of worry and anxiety from an early age. Some researchers believe that this condition affects the brain networks that connect our senses, emotions, and thoughts, causing this anxiety. Another theory is that people feel anxious because they feel something is wrong but cannot put it into words. However, this unusual worry is also a symptom that doctors consider when diagnosing PCA.
What complications can this cause?
Because PCA is a progressive disease, the initial symptoms may worsen over time, and new symptoms may appear. Here are some of the main complications that can occur:
- Functional blindness: Even though the eyes are fine, the brain cannot interpret what is seen, making it as if the person is blind.
- Depression and anxiety: Mental stress can occur with the illness, and conditions such as depression and anxiety may increase.
- Increased risk of falls: This condition can also affect the body's balance, making it more likely to fall frequently.
- Increased accidents at home: For example, accidents such as reaching for the stove's control panel and burning your hand by touching a hot part of the stove can occur because the brain does not understand where exactly what you see is.
What causes this?
The main cause of PCA is the presence of other neurodegenerative diseases that affect the brain. Often, people with PCA also have Alzheimer's disease or Lewy body dementia . These are the most common causes.
However, very rarely, other medical conditions can also cause PCA. These include:
- `(Creutzfeldt-Jakob disease)`
- `(Corticobasal degeneration)`
Is PCA a part of Alzheimer's disease?
Yes, PCA can actually be considered a variant of Alzheimer's disease . When we think of Alzheimer's disease, we usually think of memory problems first. However, in the early stages of Alzheimer's disease, other parts of the brain that are not related to memory can also be affected. Doctors call these conditions an atypical variant of Alzheimer's disease. Posterior Cortical Atrophy is one such atypical variant of Alzheimer's disease.
How is this disease diagnosed?
Doctors perform several tests to accurately diagnose PCA, as these symptoms can be caused by other causes, and they need to be ruled out.
- A brain scan (MRI - magnetic resonance imaging): This can check for atrophy in the posterior cerebral cortex.
- An eye exam: This is important to determine if these vision problems are caused by another eye condition.
- Neurological exam: This checks how the nervous system is functioning.
- Neuropsychological assessment: This tests various brain functions such as memory, attention, language ability, and visual perception.
- `(PET scan - positron emission tomography scan)`: This can also be used to see if there are any changes in brain function and Alzheimer's disease.
- Lumbar puncture / spinal tap: This tests the fluid in the brain and spinal cord for proteins associated with Alzheimer's disease.
What is the treatment for this?
To be honest, there is no cure for PCA yet. But don't worry. There are things you can do to manage the symptoms, slow the progression of the disease, and make your life easier.
Doctors first determine the underlying cause of the condition, such as Alzheimer's disease or Lewy body dementia. Then they treat the underlying condition. There are medications approved by the US Food and Drug Administration to help slow the progression of the disease.
It also refers to various programs and services that help people live with the symptoms.
- Medicines:
- `(Donepezil)` (Donepezil)
- `(Rivastigmine)` (Rivastigmine)
- `(Galantamine)` (Galantamine)
- `(Lecanemab)` (Lecanemab)
These are the medications commonly given for Alzheimer's disease.
If you have conditions like anxiety or depression, you may also be given medication (anti-anxiety medication, antidepressants) for those.
- Other treatments and services:
- Cognitive rehabilitation: You can learn exercises and techniques that help improve things like memory and attention.
- Occupational therapy: This helps you learn coping strategies and adapt your environment so that you can do daily tasks on your own.
- Physical therapy: This provides exercises that help with things like balance and walking.
- Mental health counseling: Counseling is very important to manage the stress and anxiety that comes with this condition.
What to expect if your loved one has PCA?
PCA is a condition that gradually worsens over time. So, you can expect your loved one's symptoms to gradually worsen. Eventually, they may develop symptoms that are very similar to those of someone with advanced Alzheimer's disease. While this is sad to know, we need to be prepared to deal with it.
What is the life expectancy of someone with PCA?
The life expectancy of someone with PCA is generally very similar to that of someone with Alzheimer's disease. After the first symptoms of Alzheimer's begin, most people live about 10 to 12 years .
However, it is important to remember this: This is just a general guideline. It can vary from person to person. Your situation may be different. Therefore, it is best to ask your doctor about this.
How do I care for my loved one with PCA?
If your loved one has PCA, caring for them is a big responsibility, and it requires a lot of love. The most important thing to do first is to try to understand how they see the world.
Imagine, he bumps into a table. It's not because he doesn't 'see' the table. It's because his eyes send a signal to his brain that the table is there, but the brain doesn't properly understand it and respond by saying, 'There's a table over there, you need to make way.'
In times like these, one solution is to keep the pathways between rooms clear. You can remove unnecessary items and reduce the chances of them tripping. This is just one suggestion. The medical team caring for your loved one will give you many other suggestions to help them stay safe at home and elsewhere, and to help them do their jobs independently .
- Be patient: It can take them a long time to understand things and get things done.
- Speak clearly and simply: Instead of saying too many things at once, say one thing simply.
- Create a safe environment: Reduce slippery and bumpy areas. Keep lights on at night.
- Understand their feelings: This is difficult for them too. Understand their sadness and anger.
- Take care of yourself too: When caring for a loved one, it is very important to maintain your own mental and physical health.
When should I see a doctor?
The symptoms of PCA tend to get worse over time. If you have this condition, talk to your doctor about what to expect in the coming months and years.
Also, ask about any symptoms that may indicate a worsening of your condition, and whether you should contact your doctor if you notice any. If you develop a new symptom or if an existing symptom suddenly worsens, seek medical advice immediately.
What questions should I ask my doctor?
Because PCA is a rare condition, you may have many questions about it. Don't be afraid to ask your doctor about everything. For example:
- 'Doctor, how do you know for sure that I have `(Posterior Cortical Atrophy)`?'
- 'What is causing this change in my brain function?'
- 'What can I do about my current symptoms?'
- 'Is there any medicine that can reduce these symptoms?'
- 'How will this situation affect my daily life?'
- 'What changes should I expect in the next few months, years?'
- 'What is the best way for me to plan for the future?'
What is the message we want to take home from this story?
Posterior Cortical Atrophy (PCA) is a condition that can be difficult to deal with and can have a significant impact on your life. Because of the changes in the way your brain processes what you see, it can make it difficult to perform everyday tasks, such as reading, working with numbers, and judging distance. This can cause a lot of anxiety and fear. You may also feel like you won't be able to do your work on your own.
Although there is no cure for this condition, you don't have to face it alone. There are many things you can do to help manage your symptoms, adjust to this new lifestyle, and live independently for as long as possible. If you have PCA, talk to your healthcare team about it. They will be more than happy to help you and provide you with the resources you need. With the support and encouragement you need, you can make this journey.
` Posterior Cortical Atrophy, PCA, Brain Disease, Vision Problems, Alzheimer's, Dementia, Neurological Disease
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