Postencephalitic stereotyped involuntary movements responsive to L-Dopa.
Identifieur interne : 001E29 ( Ncbi/Curation ); précédent : 001E28; suivant : 001E30Postencephalitic stereotyped involuntary movements responsive to L-Dopa.
Auteurs : F. Picard [France] ; A. De Saint-Martin ; E. Salmon ; E. Hirsch ; C. MarescauxSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1996.
English descriptors
- KwdEn :
- Adult, Bromocriptine (administration & dosage), Bromocriptine (therapeutic use), Dopamine Agonists (administration & dosage), Dopamine Agonists (therapeutic use), Drug Therapy, Combination, Encephalitis (complications), Encephalitis (physiopathology), Humans, Levodopa (administration & dosage), Levodopa (pharmacology), Levodopa (therapeutic use), Magnetic Resonance Imaging, Male, Parkinson Disease, Secondary (complications), Parkinson Disease, Secondary (drug therapy), Putamen (physiopathology), Receptors, Dopamine D2 (drug effects), Stereotyped Behavior, Tomography, X-Ray Computed, Trihexyphenidyl (administration & dosage), Trihexyphenidyl (therapeutic use).
- MESH :
- chemical , administration & dosage : Bromocriptine, Dopamine Agonists, Levodopa, Trihexyphenidyl.
- chemical , drug effects : Receptors, Dopamine D2.
- chemical , pharmacology : Levodopa.
- chemical , therapeutic use : Bromocriptine, Dopamine Agonists, Levodopa, Trihexyphenidyl.
- complications : Encephalitis, Parkinson Disease, Secondary.
- drug therapy : Parkinson Disease, Secondary.
- physiopathology : Encephalitis, Putamen.
- Adult, Drug Therapy, Combination, Humans, Magnetic Resonance Imaging, Male, Stereotyped Behavior, Tomography, X-Ray Computed.
Abstract
In 1954, at the age of 5 years, our patient had an encephalitic syndrome associated with a prolonged lethargic state. After this episode, he developed a severe parkinsonian syndrome that, after a few years, was associated with axial dystonia and stereotyped abnormal movements of the upper limbs. This complex and progressive extrapyramidal syndrome had many similarities to the encephalitis lethargica as described by von Economo. Results of cerebral computed tomography and magnetic resonance imaging were normal. Fluorodopa positron emission tomography showed a significant bilateral reduction of tracer accumulation in both putamen, similar to that observed in patients with idiopathic Parkinson's disease. However, in this patient, treatment with L-Dopa suppressed all akinetic, dystonic and dyskinetic symptoms. The effectiveness of L-Dopa was abolished by administration of a D2 antagonist and was fully reproduced by a D2 agonist. In conclusion, this patient presented a complex postencephalitic, extrapyramidal syndrome, with akinetic symptoms and involuntary movements. These symptoms appeared to be related to a limited lesion of the dopaminergic neurons of the zona compacta of the substantia nigra.
DOI: 10.1002/mds.870110513
PubMed: 8866499
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pubmed:8866499Le document en format XML
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<term>Dopamine Agonists (therapeutic use)</term>
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<term>Tomography, X-Ray Computed</term>
<term>Trihexyphenidyl (administration & dosage)</term>
<term>Trihexyphenidyl (therapeutic use)</term>
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<front><div type="abstract" xml:lang="en">In 1954, at the age of 5 years, our patient had an encephalitic syndrome associated with a prolonged lethargic state. After this episode, he developed a severe parkinsonian syndrome that, after a few years, was associated with axial dystonia and stereotyped abnormal movements of the upper limbs. This complex and progressive extrapyramidal syndrome had many similarities to the encephalitis lethargica as described by von Economo. Results of cerebral computed tomography and magnetic resonance imaging were normal. Fluorodopa positron emission tomography showed a significant bilateral reduction of tracer accumulation in both putamen, similar to that observed in patients with idiopathic Parkinson's disease. However, in this patient, treatment with L-Dopa suppressed all akinetic, dystonic and dyskinetic symptoms. The effectiveness of L-Dopa was abolished by administration of a D2 antagonist and was fully reproduced by a D2 agonist. In conclusion, this patient presented a complex postencephalitic, extrapyramidal syndrome, with akinetic symptoms and involuntary movements. These symptoms appeared to be related to a limited lesion of the dopaminergic neurons of the zona compacta of the substantia nigra.</div>
</front>
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