MediGence: Enabling Better Health Decisions

Mrs Shobha Lamichhane, a 62-year-old woman from Nepal, travelled to India after experiencing neurological symptoms for approximately 1-2 years, including tremors in her left upper limb, slowed movement and walking, and slurred speech.

Before travelling to India, she had been evaluated and treated in Nepal as a case of Parkinson's disease. However, her clinical presentation prompted the need for a more detailed specialist assessment to determine whether her symptoms were consistent with typical Parkinson's disease or another form of Parkinsonism.

For Mrs Lamichhane and her family, obtaining a comprehensive neurological evaluation was an important step toward understanding her condition and determining the appropriate next steps in care.

Finding Specialised Neurological Care in India

Seeking further neurological evaluation and access to advanced diagnostic facilities, Mrs Lamichhane travelled from Nepal to India.

MediGence supported her medical journey by helping coordinate her arrangements in India, sharing suitable accommodation options, and assisting with her hospital visit. She arrived in India on 28 July 2026, where the MediGence team received her at the airport and assisted her and her accompanying family member with transportation to the selected accommodation.

She subsequently attended a neurology consultation at Artemis Hospital, Gurugram, with Dr Sumit Singh on 30 July 2026.

Specialist Evaluation at Artemis Hospital

During the consultation, Dr Sumit Singh reviewed Mrs Lamichhane's medical history and clinical symptoms. Based on the assessment, the presentation was considered not entirely typical of straightforward or idiopathic Parkinson's disease.

An atypical Parkinsonian syndrome was therefore considered, with corticobasal degeneration documented as a provisional differential diagnosis. This was not a confirmed diagnosis.

To further evaluate the underlying neurological condition, the specialist recommended a series of investigations, including brain MRI with contrast, F-DOPA PET/Fluorodopa brain imaging, sleep EEG, Anti-IgLON5 antibody testing, and several laboratory investigations.

Advanced F-DOPA Radionuclide Imaging

As part of the recommended diagnostic evaluation, Mrs Lamichhane underwent F-DOPA radionuclide imaging at ArtemisHospital on 30 July 2026.

F-DOPA imaging is a specialised nuclear medicine investigation that can provide information about dopaminergic function in the brain. In patients presenting with Parkinsonian symptoms, such imaging may form part of a broader neurological assessment when the clinical picture requires further evaluation.

For Mrs Lamichhane, the investigation was performed as part of the specialist-led diagnostic work-up. The available medical records indicate that the formal imaging report and the results of the remaining recommended investigations were required for complete diagnostic assessment.

Continued Neurological Management During Evaluation

As the diagnostic evaluation progressed, Mrs Lamichhane continued to receive clinical management for her Parkinsonian symptoms under specialist supervision. The focus remained on controlling her symptoms while further investigations were being completed to better understand the underlying neurological condition.

Since the clinical assessment raised the possibility of atypical Parkinsonism, ongoing specialist review and interpretation of the recommended investigations remained important for establishing the final diagnosis and determining the appropriate long-term care plan.

A Coordinated Medical Journey

Throughout Mrs Lamichhane's stay in India, MediGence assisted with different aspects of her medical journey, including pre-arrival coordination, accommodation assistance, airport reception and transfer, hospital coordination, consultation support, investigation coordination, and communication whenever required.

The objective was to help Mrs Lamichhane and her family navigate the healthcare process while she underwent specialist neurological evaluation and advanced diagnostic testing.

Returning Home With Further Evaluation Planned

Mrs Lamichhane completed her planned medical visit in India and returned to Nepal on 11 August 2026.

At the time of completion of her visit, her condition remained under neurological evaluation. The working clinical impression was Parkinsonian syndrome with suspected atypical Parkinsonism, while corticobasal degeneration remained a provisional differential diagnosis rather than a confirmed diagnosis.

Further review of the investigation results and neurological follow-up would be required to establish the final diagnosis and determine the appropriate ongoing management.

A Journey Toward Diagnostic Clarity

Mrs Lamichhane's journey highlights the importance of specialist neurological assessment when Parkinsonian symptoms do not follow a typical clinical pattern. Her decision to seek further evaluation in India enabled her to access specialist neurological consultation and advanced diagnostic imaging, including F-DOPA radionuclide imaging.

With support from Dr Sumit Singh and the team at Artemis Hospital, along with coordination from MediGence, Mrs Lamichhane was able to undergo a more comprehensive evaluation of her neurological condition.

MediGence remains committed to supporting Mrs Lamichhane and her family with future consultations, investigation reviews, hospital coordination, or other medical travel requirements as needed. We sincerely wish Mrs Lamichhane continued strength and the best possible outcome as she proceeds with her neurological follow-up.