Worsened postural deformity in multiple-system atrophy patients with excessive dopaminergic treatment
- Author:
Banu Ozen Barut
;
Armagan Varol
;
Enes Demiryürek
;
Ufuk Emre
;
Hüseyin Tugrul Atasoy
- Publication Type:Journal Article
- From:Neurology Asia
2013;18(4):415-418
- CountryMalaysia
- Language:English
-
Abstract:
Postural deformities like dropped head, camptocormia, and Pisa syndrome are seen in both Parkinson’s
disease and multiple-system atrophy (MSA). However, these features are relatively more common
in MSA. These deformities may worsen during treatment and cause the patient distress. We report
here two MSA patients. The first patient was a 53-year-old woman with severe bradykinesia, rigidity,
and orthostatic hypotension developed dropped head after increasing her levodopa dose from 400 to
600 mg/day. This symptom improved when we reduced the levodopa dose back to 400 mg/day. The
second was a 59-year-old woman with severe bradykinesia, rigidity, and urinary incontinence who
showed putaminal atrophy on magnetic resonance imaging. After Pisa syndrome was observed at her
last follow-up visit, we decreased the pramipexole dose from 4.5 to 3 mg, and she improved.
In conclusion, postural deformities in MSA patients may worsen with higher doses of dopaminergic
treatment, and decreasing the dose may be the treatment of choice in these patients.
- Full text:P020150702613162085196.pdf
