A Unique Case of Coincidence of Early Onset Parkinson's Disease and Multiple Sclerosis
Identifieur interne : 001831 ( PascalFrancis/Checkpoint ); précédent : 001830; suivant : 001832A Unique Case of Coincidence of Early Onset Parkinson's Disease and Multiple Sclerosis
Auteurs : Peter Valkovic [Slovaquie] ; Georgi Krastev [Slovaquie] ; Miroslav Mako [Slovaquie] ; Petra Leitner [Allemagne] ; Thomas Gasser [Allemagne]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
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- Pascal (Inist)
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Abstract
We report on a patient who developed left arm rest/postural tremor at age 24 and responded well to tri-hexyphenidyl. One year later spastic paraparesis appeared, and multiple sclerosis was diagnosed on the basis of clinical, radiological, and laboratory evidence. Although paraparesis improved after immunosuppressant therapy, a complete picture of an asymmetric parkinsonian syndrome gradually developed. Excellent response to levodopa, drug-induced dyskinesias, and DaTSCAN revealing pathology congruent with Parkinson's disease (PD) indicate a coincidental etiopathogenetic relationship of both clinical entities: multiple sclerosis and PD. Genetic analyses focusing on autosomal recessive parkinsonism (parkin, DJ1, and PINK1) were negative. To the best of our knowledge, only 15 cases of parkinsonism in association with multiple sclerosis have been reported, and their relationship has been interpreted to be either causal or coincidental. This is the first report of a coincidence of both entities, in which the parkinsonian syndrome developed first and before age 30.
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Krastev</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Trnavian University Hospital</s1><s2>Trnava</s2><s3>SVK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Slovaquie</country><wicri:noRegion>Trnava</wicri:noRegion></affiliation></author><author><name sortKey="Mako, Miroslav" sort="Mako, Miroslav" uniqKey="Mako M" first="Miroslav" last="Mako">Miroslav Mako</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Trnavian University Hospital</s1><s2>Trnava</s2><s3>SVK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Slovaquie</country><wicri:noRegion>Trnava</wicri:noRegion></affiliation></author><author><name sortKey="Leitner, Petra" sort="Leitner, Petra" uniqKey="Leitner P" first="Petra" last="Leitner">Petra Leitner</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of 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Neurology, School of Medicine, Comenius University</s1><s2>Bratislava</s2><s3>SVK</s3><sZ>1 aut.</sZ></inist:fA14><country>Slovaquie</country><wicri:noRegion>Bratislava</wicri:noRegion></affiliation></author><author><name sortKey="Krastev, Georgi" sort="Krastev, Georgi" uniqKey="Krastev G" first="Georgi" last="Krastev">Georgi Krastev</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Trnavian University Hospital</s1><s2>Trnava</s2><s3>SVK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Slovaquie</country><wicri:noRegion>Trnava</wicri:noRegion></affiliation></author><author><name sortKey="Mako, Miroslav" sort="Mako, Miroslav" uniqKey="Mako M" first="Miroslav" last="Mako">Miroslav Mako</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, Trnavian University Hospital</s1><s2>Trnava</s2><s3>SVK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 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Tübingen</s1><s2>Tübingen</s2><s3>DEU</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Multiple sclerosis</term><term>Nervous system diseases</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie du système nerveux</term><term>Maladie de Parkinson</term><term>Sclérose en plaques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report on a patient who developed left arm rest/postural tremor at age 24 and responded well to tri-hexyphenidyl. One year later spastic paraparesis appeared, and multiple sclerosis was diagnosed on the basis of clinical, radiological, and laboratory evidence. Although paraparesis improved after immunosuppressant therapy, a complete picture of an asymmetric parkinsonian syndrome gradually developed. Excellent response to levodopa, drug-induced dyskinesias, and DaTSCAN revealing pathology congruent with Parkinson's disease (PD) indicate a coincidental etiopathogenetic relationship of both clinical entities: multiple sclerosis and PD. Genetic analyses focusing on autosomal recessive parkinsonism (parkin, DJ1, and PINK1) were negative. To the best of our knowledge, only 15 cases of parkinsonism in association with multiple sclerosis have been reported, and their relationship has been interpreted to be either causal or coincidental. This is the first report of a coincidence of both entities, in which the parkinsonian syndrome developed first and before age 30.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>22</s2></fA05><fA06><s2>15</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>A Unique Case of Coincidence of Early Onset Parkinson's Disease and Multiple Sclerosis</s1></fA08><fA11 i1="01" i2="1"><s1>VALKOVIC (Peter)</s1></fA11><fA11 i1="02" i2="1"><s1>KRASTEV (Georgi)</s1></fA11><fA11 i1="03" i2="1"><s1>MAKO (Miroslav)</s1></fA11><fA11 i1="04" i2="1"><s1>LEITNER (Petra)</s1></fA11><fA11 i1="05" i2="1"><s1>GASSER (Thomas)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Trnavian University Hospital</s1><s2>Trnava</s2><s3>SVK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></fA14><fA14 i1="02"><s1>2nd Department of Neurology, School of Medicine, Comenius University</s1><s2>Bratislava</s2><s3>SVK</s3><sZ>1 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen</s1><s2>Tübingen</s2><s3>DEU</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></fA14><fA20><s1>2278-2281</s1></fA20><fA21><s1>2007</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000162671070220</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>15 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0071418</s0></fA47><fA60><s1>P</s1><s3>CC</s3></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>We report on a patient who developed left arm rest/postural tremor at age 24 and responded well to tri-hexyphenidyl. One year later spastic paraparesis appeared, and multiple sclerosis was diagnosed on the basis of clinical, radiological, and laboratory evidence. Although paraparesis improved after immunosuppressant therapy, a complete picture of an asymmetric parkinsonian syndrome gradually developed. Excellent response to levodopa, drug-induced dyskinesias, and DaTSCAN revealing pathology congruent with Parkinson's disease (PD) indicate a coincidental etiopathogenetic relationship of both clinical entities: multiple sclerosis and PD. Genetic analyses focusing on autosomal recessive parkinsonism (parkin, DJ1, and PINK1) were negative. To the best of our knowledge, only 15 cases of parkinsonism in association with multiple sclerosis have been reported, and their relationship has been interpreted to be either causal or coincidental. 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