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
77 -year-old male, retired public employee, left hemiparkinsonism onset 4 years before quake.
Clinical Characteristics
Diagnosed originally with unipolar major depression 6 years prior to secondary diagnosis of parkinsonism. Hot cross bun sign observed 2 years before quake suggesting msa-p. Symptoms evolved to bilateral parkinsonism with mixed rest and postural tremor, microphemia, and freezing episodes. 2 months before quake updrs motor score was 37, freezing was unpredictable at a updrs score of 4, orighthostatic hypotension observed. Mmse of 24.
Remission Characteristics
11 days after quake severe anxiety with panic attacks are reported, updrs was 23, freezing reported to have disappeared, 5 months after quake updrs motor score was 29 and freezing became occasional.
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
Magnesium valproate for unipolar major depression, but withdrew. 2 years after onset, l-dopa/carbidopa 600mg/day. 4 years from onset and 2 months before quake, l-dopa 900mg/day, and midodrine t.i.d. L-dopa 150 at night for hypotension
Non-Clinical Treatment
Earthquake (life-threatening event)