Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Clinical features and diagnosis of Alzheimer disease. These can be found on our Learning page. When my father was in his terminal year, I discussed death with him. Because the first symptoms are often visual, posterior cortical atrophy can be misdiagnosed as a vision disorder. It is progressive and terminal, the brain tissue shrinks which causes loss of cells. 2023 The Regents of the University of California, UCSF Benioff Childrens Hospital San Francisco, Langley Porter Psychiatric Hospital and Clinics, Alzheimers Disease Education and Referral (ADEAR) Center, Northern California and Northern Nevada chapter, Home Safety Tips & Recommendations for People with Visual Dysfunction, Rare Dementia Support: Posterior Cortical Atrophy Support, Posterior Cortical Atrophy Support Group on Facebook, International Consensus on the First Diagnostic Guidelines for Posterior Cortical Atrophy, Dementia Resources for Health Professionals, ADRC: New Approaches to Dementia Heterogeneity, Alzheimers Disease Neuroimaging Initiative (ADNI), Creation of Stem Cells from Patients with FTD, IDEAS: Imaging Dementia Evidence for Amyloid Scanning, Measuring Social Behavior in Neurodegenerative Disease. This includes vision problems. Wernickes encephalopathy, liver failure, kidney disease, and cancer are all examples of illnesses that can cause visual changes. As a result, PCA may affect a person's vision, their ability to read and write . 2019 May 13;131:216-222. doi:10.1016/j.neuropsychologia.2019.05.004, Putcha D, Brickhouse M, Touroutoglou A, Collins JA, Quimby M, Wong B, et al. how does posterior cortical atrophy kill yougovernment jobs for math majors. Please select an option below: .modal-header{ Clinical features and diagnosis of Alzheimer disease. I was initially diagnosed not with Alzheimers but with an ischaemic change, a simple loss of brain cells due to normal ageing. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Our caring team of Mayo Clinic experts can help you with your posterior cortical atrophy-related health concerns, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. The diagnosis should rule out the possibility that the symptoms were caused by a stroke, tumor or other identifiable condition. But those plans, and many other hopes for a settled family life, have been turned upside down by Teresa's dementia - a rare form called posterior cortical atrophy (PCA). Nov 4, 2012. What Causes PCA? An occipital stroke can cause symptoms similar to those of posterior cortical atrophy, but symptoms occur suddenly and do not progress. Qualitatively, cortical atrophy among the SNAP group was minimal at both baseline and M-12. The tests might include: Our caring team of Mayo Clinic experts can help you with your posterior cortical atrophy-related health concerns 2022; doi:10.1007/s00415-022-11330-5. Rare Dementia Support can provide a selection of resources and facilitate in-house training sessions in which a volunteer from our PCA Support Group can attend and share their experiences. *This image shows in which regions of the brain the cortex is abnormally thin in people . July 13, 2022. I think she was amazed to find that, of the two specialists in my area, one had no experience of PCA and therefore did not feel he could help me, and the other would only take patients over 65 I was clearly too young to have Alzheimers. Those words no longer apply for Bob Yetz. | Alzheimer's Association is a not-for-profit 501(c)(3) organization. It is better to know, though, and better for it to be known, because it has got people talking, which I rather think was what I had in mind. Prevalence is unknown, largely due to the lack of . Posterior cortical atrophy care at Mayo Clinic. That satisfied me until the next Clapham Junction day. And Im 60; thats supposed to be the new 40. She can see perfectly well but the brain does not process the image and she is effectively . A single copy of these materials may be reprinted for noncommercial personal use only. This damage of nerve cells in the parietal and occipital cortex causes, therefore, the reassembly of the visual information in . Accessed Nov. 3, 2020. 0 In the advanced stages of PCA, a person might: Our members have shared some of the tips and strategies that they have found useful in helping to manage these symptoms. Cholinesterase inhibitors approved for Alzheimers disease, like donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne), can help the symptoms of PCA by boosting the function of brain cells to compensate for damage caused by Alzheimers disease. endstream endobj 429 0 obj <>stream Once we have recognised the demon, without secrecy or shame, we can find its weaknesses. If you or a loved one develops this condition, you might not specifically complain of visual changes. how does posterior cortical atrophy kill you. HU]O0}p:qO !j !F*5w25*Y}:Vr-4Z:V4[U:;,A:.# 6$xJvz]@R*wmV~{>lE32'c|5l cSJf?oJ4`"{"846>E4| eB}MGs9Y.aC:jBvDdFr2"iKLVg^T'pSPq {mhjYveO 8 CzJ)G(G5trEB3CCY9GYsvv("G;(pa_ 6]tuZ6r}rKiKd If you would like to talk to somebody about how the issues raised here have affected you, please get in touch. The $1m I pledged to the Alzheimers Research Trust was just to make them talk a bit louder for a while. Posterior cortical atrophy has been considered a type of Alzheimers disease. %PDF-1.5 % Blood work is typically normal in posterior cortical atrophy and abnormal in metabolic encephalopathy. As each of these types of dementia continues to worsen, however, they may become so severe that some of their late-stage effects can be almost indistinguishable. In posterior cortical atrophy and Alzheimers disease, the brain contains amyloid plaques and neurofibrillary tangles. A lumbar puncture (LP), also often called a spinal tap, is an invasive diagnostic test. Some of the symptoms that people living with PCA might develop are outlined below. Was merely told my wife had Alzheimer's but there was a reference to the posterior cortex. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. People living with PCA have also found this to be a useful tool in describing their experiences. Furthermore, people with posterior cortical atrophy have degeneration in different parts of the brain than people with typical forms of Alzheimers disease, although there is often overlap between the two conditions. Mayo Clinic. Gonzlez AS, Hoffman P, Crutch S. Where words meet numbers: Comprehension of measurement unit terms in posterior cortical atrophy. A neuro-ophthalmologist specializes in neurology and conditions related to vision. People with the syndrome may not be able to recognize objects and familiar faces. Mayo Clinic. Alzheimer's Association. On the other hand, loss of visual skills, the signature feature of posterior cortical atrophy, is not typical of Alzheimers disease. Mayo Clinic does not endorse companies or products. It is a strange life, when you come out. Early symptoms of posterior cortical atrophy include blurred vision, difficulties reading (particularly following the lines of text while reading) and writing with non-visual aspects of language preserved, problems with depth perception, increased sensitivity to bright light or shiny surfaces, double vision and difficulty seeing clearly in low light conditions. por | Jun 14, 2022 | knox county grand jury indictments | quels sont vos objectifs professionnels a court et moyen terme | Jun 14, 2022 | knox county grand jury indictments | quels sont vos objectifs professionnels a court et moyen terme Also known as Benson's syndrome, posterior cortical atrophy (PCA) refers to the progressive and gradual degeneration of the cortex which is the outer layer of the brain in the part of the brain that is located in the posterior (back of the head). Therefore, people affected by PCA, including partners, carers and families, may find coming along to our PCA Support Group meetings helpful. Diana Apetauerova, MD, is board-certified in neurology with a subspecialty in movement disorders. By Heidi Moawad, MD Please consider making a contribution to help fund Being Patient's editorial costs.https://beingpatient.nationbuilder.com/---------------------------------------------------------------------------------------------------------------Stay connected on social media: To catch our Brain Talks live, join our Facebook page:https://www.facebook.com/beingpatientTo learn more about us, follow us on Instagram: @beingpatientvoices For the latest news on dementia research and lifestyle tips, visit our site:https://www.beingpatient.com/ The occipital lobes help us understand what we see, so disease in that area creates visual problems. Posterior cortical atrophy (PCA), also known as Benson's syndrome See See Posterior cortical atrophy (PCA), is a neurodegenerative syndrome characterized by progressive decline in visual processing and other functions that depend upon the occipitoparietal and occipitotemporal regions of the brain [].PCA is most frequently associated with Alzheimer's disease (AD) and is therefore . We hope it will come quickly, and be affordable. Manifestation is of progressive impairment of higher visual processing skills and other posterior cortical functions without any evidence of ocular abnormalities. In Posterior Cortical Atrophy, the disease-specific changes for Alzheimer's disease, namely the accumulation of two proteins (amyloid and tau) causes the nerve cells in the parietal and occipital cortex to be damaged. These infections typically cause a fever and an abnormal LP. Let us connect you to professionals and support options near you. It affects areas in the back of the brain responsible for spatial perception, complex visual processing, spelling and calculation. Verywell Health's content is for informational and educational purposes only. [Epub ahead of print]. There is an ongoing discussion in the field whether posterior cortical atrophy should be considered a form of Alzheimers disease or a distinct disease entity. 2021; doi:10.12998/wjcc.v4.i8.195. This is the part of our brain that processes the endstream endobj 428 0 obj <>stream Floor 17 Chicago, IL 60601, We use cookies to improve your experience on this website. We are also developing online resources designed to improve understanding of PCA and other rare dementias. No one bothered to tell me the implications and it was only through Googling her symptoms I came up with PCA . Diagnostic evaluation and monitoring of patients with posterior cortical atrophy. Noticing the signs and stages of Posterior Cortical Atrophy (PCA) Real stories https://www.uptodate.com/contents/search. Pneumonia is the cause of death in up to two thirds of people with a dementia. Only my family and the fact I had fans in the medical profession, who were able to give me useful advice, got me through that moment. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Schizophrenia typically causes behavioral changes and hallucinations, and may mimic posterior cortical atrophy. About Diagnosis Prevalence Causes and risks Symptoms Treatment About posterior cortical atrophy Different conditions cause brain atrophy, including cerebral palsy, dementia and infectious diseases. Because the first problems are perceived as eye problems, cortical brain dysfunction initially may not be considered as a cause. Mayo Clinic is a not-for-profit organization. Posterior cortical atrophy (PCA) is a rare heterogeneous, progressive neurodegenerative condition that primarily affects the occipital and parietal cortex, leading to visuoperceptual, visuospatial, praxis skills, and literacy impairment. PCA is thought to affect less than 5% of people with Alzheimers disease, although epidemiological studies are lacking and PCA has been under-recognized in the past. 2023 - Rare Dementia Support - All rights reserved. They may include: Posterior cortical atrophy care at Mayo Clinic. Schizophrenia: Psychosis is often associated with hallucinations, which are false visual or auditory stimuli. When Miltons Satan stood in the pit of hell and raged at heaven, he was merely a trifle miffed compared to how I felt on that day. Symptoms and severity of brain atrophy depend on the specific disease and location of damage. Those specialties include neurology, ophthalmology, psychiatry and psychology, radiology, pulmonary medicine, physical medicine and rehabilitation, and other areas. You can read more about cookies and how we use them on our Cookie Policy page. Characteristic features that are sometimes used for diagnosis include gradual onset of visual symptoms (described above) with preservation of normal eye function and preservation of memory. Posterior cortical atrophy is a neurodegenerative disorder that affects a person's vision. Calculation skills and the ability to make coordinated movements are affected in some cases. Posterior cortical atrophy means that a part of the brain, in the area of grey matter at the back of the parietal lobes, has begun to not work so well. It is also known as Benson's syndrome. July 13, 2022. american airlines special assistance desk phone number; bust your knee caps roblox id. Cortex. What is posterior cortical atrophy? You may need assistance with your daily activities from a professional caregiver or your family members. Researchers are looking at potential gene variations that may be related to the condition. The occipital lobes mediate visual perception, allowing people to understand and recognize what the eyes see. Make a donation. It affects the back of the brain. In more than 80% of cases, posterior cortical atrophy is due to Alzheimer's disease. Care home staff may also find our short film useful which details the everyday experiences of people living with PCA and their perception of the world around them. You can read more about these on our Living with PCA page. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. I wish I could say it was an act of bravery. National Institute on Aging. Watch film Do I see what you see?. Characterisation of Tau Imaging Ligands for Alzheimer's Disease and other Dementias, A Novel Transgenic Mouse Model to Study Platelet APP and A-beta Deposition in Stroke, Alzheimer's-Associated Beta-Amyloid Peptide and Traumatic Brain Injury: Mechanisms of Formation and Therapeutic Intervention, Apololipoprotein-E4 & Cognitive Function in Retired Boxers, Processing and Trafficking of Normal and Mutant Mammalian Prion Proteins, Aging and Neurodegeneration in Familial Prion Diseases and Alzheimer's Disease, 225 N. Michigan Ave. PCA causes atrophy of the posterior part of the cerebral cortex . It is also not known if the risk factors for Alzheimers disease are also risk factors for posterior cortical atrophy. Especially a society that cant so readily rely on those stable family relationships that traditionally provided the backbone of care in previous generations? Posterior cortical atrophy (PCA), also called Benson's syndrome, is a rare form of dementia which is considered a visual variant or an atypical variant of Alzheimer's disease (AD). PDF. It's important to see a neurologist or a neuro-ophthalmologist who can correctly diagnose your condition. They tend to gradually get worse. I grew to recognise what I came to call Clapham Junction days, when demands of the office just grew too much to deal with. 2023 Dotdash Media, Inc. All rights reserved. All rights reserved. Accessed Jan. 23, 2023. And that is nearly it for hope at the moment. An Overview of Posterior Cortical Atrophy. Posterior cortical atrophy is a type of dementia. If you or a loved one is diagnosed with posterior cortical atrophy, the effects can be frustrating. Atulkumar Singh N, et al. Posterior cortical atrophy is caused by neurodegeneration, which is the loss of neurons. It affects areas in the back of the brain responsible for spatial perception, complex visual processing, spelling and calculation. Posterior Cortical Atrophy (PCA) is a rare neurologic disease characterized by impairment of higher visual processing skills and other posterior cortical functions without any evidence of ocular abnormalities, relatively intact memory and language in the early stages. A Visual Spatial Syndrome Associated With Dementia. The disease slips you away a little bit at a time and lets you watch it happen. Dr. Moawad regularly writes and edits health and career content for medical books and publications. It can be difficult to recognize the symptoms of posterior cortical atrophy because they are related to visual abilities rather than pure visual deficits. Some people live approximately the same length of time as individuals with typical Alzheimers disease (on average 1012 years following the onset of symptoms) while others live with the condition for longer. If you have this test, a doctor would place a needle in your lower back to collect spinal fluid. how does posterior cortical atrophy kill you. The most common symptoms are consistent with damage to the posterior cortex of the brain, which is responsible for processing visual information. The patient may have trouble accurately reaching out to pick up an object. | All rights reserved. Posterior cortical atrophy (PCA), also called Benson's syndrome, is a rare, visual variant of Alzheimer's disease. Please enable Strictly Necessary Cookies first so that we can save your preferences! Read our. A neurologist is trained in brain and nervous system conditions. justify-content: center; Posterior cortical atrophy tends to affect people at an earlier age than typical Alzheimer's disease, with individuals often being in their mid-fifties or early sixties at the time of their first symptoms. Posterior cortical atrophy changes a person's ability to purposefully process visual and spatial information. In other people with posterior cortical atrophy, however, the brain changes resemble other diseases such as dementia with Lewy bodies or a form of Creutzfeldt-Jakob disease. 456 0 obj <>stream If you would be interested in contributing your experience and expertise to this work please get in touch. The baby-boomers are getting older, and will stay older for longer will expect to stay younger for longer. Wendy is a senior clinical neuropsychologist and coordinator of neuropsychology services at the Royal Melbourne Hospital in Victoria, Australia. There are some similarities and differences between posterior cortical atrophy and Alzheimers disease.. Specialized rehabilitation and vision therapy can be helpful, especially if you dont have symptoms of dementia. People may lose the ability to respond to their environment, to carry on a conversation and to control movement. This is because PCA affects how the body copes with infection and with other physical problems. People either lose it entirely or just partially. Nguyen HT. We dont know what causes it, and as far as we know the only way to be sure of not developing it is to die young. Cogn. A neurologist is trained in brain and nervous system conditions. Other less common causes include corticobasal degeneration, Lewy body dementia and Creutzfeldt-Jakob disease. Arizona Alzheimer's Consortium. Pneumonia is the cause of death in up to two thirds of people with a dementia. Some conditions like stroke, encephalitis, multiple sclerosis, or AIDS are manageable with treatment. Journal of Neurology. V5 What is needed is will and determination. For me, things came to a head in the late summer of 2007. Although its hard, talking with friends and loved ones and planning for the future is beneficial. When that happens, an. Posterior cortical atrophy. Our audience has grown so rapidly; we have exciting plans for the future to enhance our coverage even further but we need your help. These conditions are more common than posterior cortical atrophy and might be mistakenly diagnosed early in the course of the disease. hb``` ea8RAf+do? 9\sacGSGPGCG`` 52h;U 00cz Examination of higher visual functions, neuropsychological testing, and neuroimaging contribute to diagnosis. 2023 Alzheimer's Association. Common symptoms include having trouble with: Memory problems may occur later in the disease. I went back to my GP and said that I knew there was something more going on. 2019;22:101773. doi:10.1016/j.nicl.2019.101773. Here we reprint the powerful account of the condition that he wrote to fight the stigma of the illness, first published by the Alzheimers Society in 2008, Original reporting and incisive analysis, direct from the Guardian every morning, Terry Pratchett in Salisbury in 2013. In posterior cortical atrophy, the occipital lobes are smaller than would normally be expected, and this is usually apparent on brain CT and MRI examinations. North C, et al. Focal, affecting one area of the brain. This is because their brain is . how does posterior cortical atrophy kill yourotter and mischel: cognitive social learning theory summary Care Quality Commission care home finder tool, Regulation and Quality Improvement Authority, be functionally blind, requiring support in all visually-guided activities, be inconsistent in their recollection of recent events and plans, have difficulty communicating and understanding verbal and visual information, experience changes in sleep patterns (such as sleeping during the day and becoming restless at night), have trouble controlling their bladder or bowels, become more quiet and withdrawn, appearing disengaged from the environment unless addressed directly, experience behaviour and personality changes, including obsessions, compulsions, suspiciousness and delusions (believing that their caregiver is an imposter, for example), experience a further loss of sensory functions (such as a partial or complete loss of response to touch, swallowing issues or seizures). Some patients experience hallucinations. This difficulty is secondary to atrophy of the back (posterior) part of the brain. How Common Is Bruce Williss Frontotemporal Dementia? 2B^2pG This loss may be the result of an injury, infection, or underlying health condition. However, there are some measures that you can take to optimize your abilities and quality of life. However, because posterior cortical atrophy often goes unrecognized, the true percentage may be as high as 15 percent. Advertising revenue supports our not-for-profit mission. The most common symptoms are consistent with damage to the posterior cortex of the brain, an area responsible for processing visual information. accident on parkway south today; random family book photos; non denominational churches in plano, tx; just wanted to touch base with you regarding; uncle passed away message to boss The effects of posterior cortical atrophy include: Posterior cortical atrophy is often considered a variant of Alzheimer's disease, although memory loss does not usually develop until years after the disease begins.. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful. You can view the full series on the Rare Dementia Support website: raredementiasupport.org. Most cases of Alzheimers disease occur in people age 65 or older, whereas the onset of posterior cortical atrophy commonly occurs between ages 50 and 65. This changes a person's ability to process visual and spatial information. PCA was first described by D. Frank Benson in 1988. People get embarrassed, lower their voices, get lost for words. 3D3h1nAm5iVs3mxkcr< Vision tests can distinguish true vision loss from posterior cortical atrophy. In people with PCA, the visual problems are not due to problems with their eyes. how does posterior cortical atrophy kill you. Posterior cortical atrophy (PCA), also called Bensons syndrome, is a rare, visual variant of Alzheimers disease. However, in most of the inflammatory disorders other systemic symptoms are present, helping confirm the diagnosis. Regular exercise and sensible eating habits are a good idea, but they dont come with any guarantees. There is not a single definitive treatment for posterior cortical atrophy. My typing had been getting progressively worse and my spelling had become erratic. 2022; doi:10.1007/s11910-022-01238-y. It causes problems with eyesight and with processing visual information. This is the region responsible for visual processing and spatial reasoning. If you or a loved one has been diagnosed with posterior cortical atrophy, there is no doubt that it can be challenging. Posterior cortical atrophy is a progressive degenerative condition involving the loss and dysfunction of brain cells, particularly at the posterior (back) of the brain. Some research suggests that medicines used to slow the progression of Alzheimer's disease may help manage symptoms of posterior cortical atrophy. Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterised by progressive decline in visuospatial, visuoperceptual, literacy, and praxic skills. A major difference between the conditions is that Alzheimers disease is usually characterized by atrophy of the medial portions of the temporal lobes, resulting in difficulties with short-term memory early in the course of the disease. Researchers are talking about the possibility of a whole palette of treatments or regimes to help those people with dementia to live active and satisfying lives, with the disease kept in reasonably permanent check in very much the same way as treatments now exist for HIV. National Institute on Aging. It is important that care home staff are aware of the specific needs of someone living with PCA. Arizona Alzheimer's Consortium. Support is a fund held by the National Brain Appeal. PCA causes damage and deterioration to the back - or posterior - area of the brain. Atrophy of the brain can affect different areas, depending on the disease involved. Posterior cortical atrophy. This is a moot point, but what it does do, while gradually robbing you of your memory, visual acuity and other things you didn't know you had until you miss them, is leave you more or. Symptoms also can vary over time. They may also lose the ability to smile, to sit without support and to hold their heads up. Loss of visual skills is the predominant effect of this condition. Although no cure for posterior cortical atrophy exists, several medications, as well as many non-pharmaceutical approaches, can potentially improve daily functioning and quality of life. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Although PCA is itself a life-shortening condition, people with PCA are often affected by another illness such as pneumonia. There are no treatments for posterior cortical atrophy known to slow or halt its progression. We still have the occasional Clapham Junction days, now understood and dealt with. This page aims to guide all those affected by a diagnosis of posterior cortical atrophy (PCA) through the more advanced stages of the condition. In the vast majority of PCA cases, the underlying cause is Alzheimers disease, and the brain tissue at autopsy shows an abnormal accumulation of the proteins amyloid and tau that form the plaques and tangles seen in Alzheimers disease. About the Alzheimer's Consortium. Find out more about third-party cookies on our Cookie policy page. Your physical examination includes a neurological examination, which assesses muscle strength, reflexes, sensation, coordination, walking, vision, speech, and memory. The posterior cerebral cortex of the brain includes the left and right occipital lobes, which are adjacent to each other. Please click here to watch an updated version of this film http://www.youtube.com/watch?v=nOxodew_ngo The changes in the brain resemble those in someone with Alzheimer's disease but the effects are very different. Mayo Clinic. At Mayo Clinic, specialists trained in several areas care for people who have posterior cortical atrophy and related conditions. Pelak VS, et al. However, it can also affect older people. The progressive . I felt that all I had was a voice and I should make it heard. This content does not have an Arabic version. Foveal crowding in posterior cortical atrophy: a specific early-visual-processing deficit affecting word reading. "Seeing is believing," an old saying advises. Posterior Cortical Atrophy: Is it Alzheimer's or a Different Type of Dementia - YouTube Being Patient Perspectives: we speak with Deb Jobe about her diagnosis with posterior cortical. This indicates that the individual has experienced a decrease in brain volume. Nguyen HT. https://azalz.org/about/#institutes. On the other hand and this is very typical of PCA when the kind lady who periodically checks me out asks me to name as many animals as I can, I started with the rock hyrax, the nearest living relative to the elephant, and the thylacine the probably extinct Tasmanian marsupial wolf. For those living in other parts of the UK, the following sites can provide similar services: Wales: Care Inspectorate WalesScotland: Care InspectorateNorthern Ireland: Regulation and Quality Improvement Authority. The tests also might rule out other conditions that may cause similar symptoms. lunar house croydon contact number,
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