Protracted Benet From Paradoxical Kinesia In Typical And Atypical Parkinsonisms
Bonanni, L., Thomas, A., Anzellotti, F., monthsaco, D., Ciccocioppo, F., Varanese, S., Bifolchetti, S., D'Amico, M. C., Di Iorio, A., & Onofrj, M. (2010). Protracted benefit from paradoxical kinesia in typical and atypical parkinsonisms. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 31(6), 751–756. https://doi.org/10.1007/s10072-010-0403-5
View Original Source →Case Details
Disease Location
Basal ganglia
Personal Characteristics
90 -year-old female had ipd for 3 years with dementia (ipd-d).
Clinical Characteristics
Left arm tremor and rigidity appeared 8 years before quake. MRI 1 year before quake showed subcortical hypointensity in t2, interpreted as vasular lacunae. Mmse 24, rbd, visual hallucinations in last two years, parkinsonism worsened in 3 years with updrs motor score going from 29 to 48. Patient had campatientocormia, updrs score of 4, fog-q of 24. Bedridden for a year before quake with a updrs gait score of 4 out of 62, h/y stage 5.
Remission Characteristics
15 days after quake was able to walk while assisted rather than in a wheelchair. Gait score was 3 out of a updrs motor score of 38. Updrs freezing score was a 2, fog-q was a 9. 5 months after the quake, updrs motor score raised to 57, freezing to 4, and fog-q to 24.
Treatment & Mechanisms
Proposed Remission Mechanisms
Noradrenergic augmentation (effect of a life threatening event)/different noradrenergic responses to stress compensatory activation of cerebellar circuitry activation of basal ganglia reserves pk may occur in patients with core and supportive elements typical of ipd-d or dlb
Clinical Treatment
L-dopa cabidopa 600mg/day, quetiapine 25mg at night, rasagiline 1.5mg/day
Non-Clinical Treatment
Earthquake (life-threatening event)