Neuronal intranuclear inclusion disease: two cases of dopa-responsive juvenile parkinsonism with drug-induced dyskinesia.
Identifieur interne : 001756 ( PubMed/Corpus ); précédent : 001755; suivant : 001757Neuronal intranuclear inclusion disease: two cases of dopa-responsive juvenile parkinsonism with drug-induced dyskinesia.
Auteurs : Szu-Chia Lai ; Shih-Ming Jung ; Padraic Grattan-Smith ; Ella Sugo ; Yen-Wen Lin ; Rou-Shayn Chen ; Chiung-Chu Chen ; Yah-Huei Wu-Chou ; Anthony E. Lang ; Chin-Song LuSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Adolescent, Antiparkinson Agents (adverse effects), Child, Dyskinesia, Drug-Induced (etiology), Dyskinesia, Drug-Induced (pathology), Female, Humans, Intranuclear Inclusion Bodies (metabolism), Intranuclear Inclusion Bodies (pathology), Levodopa (adverse effects), Male, Neurons (metabolism), Neurons (pathology), Parkinsonian Disorders (drug therapy), Parkinsonian Disorders (pathology), Peptides (metabolism), Taiwan, Ubiquitin (metabolism).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , metabolism : Ubiquitin.
- geographic : Taiwan.
- drug therapy : Parkinsonian Disorders.
- etiology : Dyskinesia, Drug-Induced.
- metabolism : Intranuclear Inclusion Bodies, Neurons, Peptides.
- pathology : Dyskinesia, Drug-Induced, Intranuclear Inclusion Bodies, Neurons, Parkinsonian Disorders.
- Adolescent, Child, Female, Humans, Male.
Abstract
There are very few conditions that present with dopa-responsive juvenile parkinsonism. We present two such children with neuronal intranuclear inclusion disease (NIID) who had an initial good levodopa response that was soon complicated by disabling dopa-induced dyskinesia. One child was diagnosed by rectal biopsy in life, and the other diagnosis was confirmed at postmortem. In this patient, dopamine transporter imaging showed severely decreased binding of the radiotracer in the striatum on both sides. Bilateral subthalamic deep brain stimulation in this patient produced initial improvement, but this was not sustained. Both patients died within 10 years of symptom onset. As well as levodopa responsiveness with rapid onset of dyskinesia, clues to the diagnosis of NIID in patients presenting with parkinsonism include the presence of gaze-evoked nystagmus, early onset dysarthria and dysphagia and oculogyric crises. Differential diagnosis of clinical symptoms and neuropathological findings are discussed including the approach to rectal biopsy for early diagnosis.
DOI: 10.1002/mds.22876
PubMed: 20629123
Links to Exploration step
pubmed:20629123Le document en format XML
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<front><div type="abstract" xml:lang="en">There are very few conditions that present with dopa-responsive juvenile parkinsonism. We present two such children with neuronal intranuclear inclusion disease (NIID) who had an initial good levodopa response that was soon complicated by disabling dopa-induced dyskinesia. One child was diagnosed by rectal biopsy in life, and the other diagnosis was confirmed at postmortem. In this patient, dopamine transporter imaging showed severely decreased binding of the radiotracer in the striatum on both sides. Bilateral subthalamic deep brain stimulation in this patient produced initial improvement, but this was not sustained. Both patients died within 10 years of symptom onset. As well as levodopa responsiveness with rapid onset of dyskinesia, clues to the diagnosis of NIID in patients presenting with parkinsonism include the presence of gaze-evoked nystagmus, early onset dysarthria and dysphagia and oculogyric crises. Differential diagnosis of clinical symptoms and neuropathological findings are discussed including the approach to rectal biopsy for early diagnosis.</div>
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