There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.
Adult ; Brain Neoplasms ; Dementia ; Female ; Humans ; Lewy Body Disease ; Meningioma ; Parkinson Disease, Secondary ; Parkinsonian Disorders

¹²³I-meta-iodobenzylguanidine (MIBG) has become widely applied in Japan since its introduction to clinical cardiology and neurology practice in the 1990s. Neurological studies found decreased cardiac uptake of ¹²³I-MIBG in Lewy-body diseases including Parkinson's disease and dementia with Lewy bodies. Thus, cardiac MIBG uptake is now considered a biomarker of Lewy body diseases. Although scintigraphic images of ¹²³I-MIBG can be visually interpreted, an average count ratio of heart-to-mediastinum (H/M) has commonly served as a semi-quantitative marker of sympathetic activity. Since H/M ratios significantly vary according to acquisition and processing conditions, quality control should be appropriate, and quantitation should be standardized. The threshold H/M ratio for differentiating Lewy-body disease is 2.0-2.1, and was based on standardized H/M ratios to comparable values of medium-energy collimators. Parkinson's disease can be separated from various types of parkinsonian syndromes using cardiac ¹²³I-MIBG, whereas activity is decreased on images of Lewy-body diseases using both ¹²³I-ioflupane for the striatum and ¹²³I-MIBG. Despite being a simple index, the H/M ratio of ¹²³I-MIBG uptake is reproducible and can serve as an effective tool to support a diagnosis of Lewy-body diseases in neurological practice.
3-Iodobenzylguanidine ; Cardiology ; Dementia ; Diagnosis ; Japan ; Lewy Bodies ; Lewy Body Disease ; Neurology ; Nuclear Medicine ; Parkinson Disease ; Parkinsonian Disorders ; Quality Control

We experienced clinical improvement by clozapine(mean maintenance dosage: 100mg/day) and antiparkinsonian medication in 68-year-old man, diagnosed both secondary parkinsonism and delusional disorder. This result supports previous reports that clozapine may effectively treat parkinsonism with psychosis.
Aged ; Clozapine* ; Delusions* ; Humans ; Parkinson Disease, Secondary ; Parkinsonian Disorders* ; Psychotic Disorders ; Schizophrenia, Paranoid*

Hemiparkinsonism with hemiatrophy (HP-HA) syndrome is characterized by a predominant unilateral parkisonism associated with ipsilateral body and/or contralateral brain abnormality. We report three cases of Hemiparkinsonism- hemiatrophy, which is a rare form of secondary parkinsonism. One patient revealed motor complication in the involved limb suggesting that the degeneration of nigrostriatal pathway as the underlying mechanism in this disorder. The functional neuro-imaging can play an important role to verify the cortical abnormalities when structural changes are not evident in brain MRI.
Brain ; Extremities ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Parkinson Disease, Secondary ; Parkinsonian Disorders

A case of Lewy body dementia in a 71 year-old male patient was reported and related articles were also reviewed. He has been ill with Parkinsonism since 1988, and referred to the neuropsychiatrist because of depression since 1989. Episodically he has experienced dizziness, falls and low blood pressure. Mild cognitive decline including memory, attention, language, and visuospatial ability accompanied by occasional fluctuation of consciousness, confusion, visual hallucination and disorientation was developed on February 9th in 2000. Such symptoms were repeated thereafter, and responded on donepezil in addition to the antiparkinsonian drugs.
Aged ; Consciousness ; Depression ; Dizziness ; Hallucinations ; Humans ; Hypotension ; Lewy Bodies* ; Lewy Body Disease* ; Male ; Memory ; Parkinsonian Disorders

Head trauma has been mentioned as an uncommon cause of secondary Parkinsonism. We report a 68-year-old woman who developed a rapidly evolving post-traumatic encephalopathy with predominant akinetic-rigid syndrome. The clinical manifestations were mainly bradykinesia, rigidity, cognitive dysfunction and emotional lability. Brain SPECT showed perfusion defect in the left basal ganglia and thalamus. The parkinsonian symptoms improved moderately with levodopa.
Aged ; Basal Ganglia ; Brain Injuries* ; Brain* ; Craniocerebral Trauma ; Female ; Humans ; Hypokinesia ; Levodopa ; Parkinson Disease, Secondary ; Parkinsonian Disorders ; Perfusion ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

Parkinsonism secondary to intracranial mass lesions usually results from compression or distortion of the basal ganglia. Secondary parkinsonism due to midbrain infiltration or compression is rare and generally associated with other neurologic signs caused by pyramidal tract and/or cranial nerve involvement. We report a case of 30-year-old woman in whom mild parkinsonism was the major clinical manifestation of an astrocytoma in the anterior third ventricle and hypothalamus. She underwent surgical resection, ventriculoperitoneal shunt and radiation therapy. All symptoms of parkinsonism were completely recovered 3 months after the treatment. Brain tumors can be manifested only by the symptoms of parkinsonism. This case emphasizes the significance of neuroimaging in the evaluation of parkinsonism.
Adult ; Astrocytoma ; Basal Ganglia ; Brain Neoplasms ; Cranial Nerves ; Female ; Humans ; Hypothalamus ; Mesencephalon ; Neuroimaging ; Neurologic Manifestations ; Parkinson Disease, Secondary ; Parkinsonian Disorders ; Pyramidal Tracts ; Third Ventricle ; Ventriculoperitoneal Shunt

Parkinsonism is characterized by clinical symptoms of rigidity, bradykinesia, tremor, and gait disturbance. There are many causes of secondary parkinsonism. The present report discusses a secondary parkinsonism of extrapontine myelinolysis (EPM) without central pontine myelinolysis (CPM) after rapid correction of hyponatremia. EPM is a demyelinating process of the brain. EPM with CPM is relatively common, but EMP without CPM is rare. A 57- year-old woman with Tsutsugamushi disease had a subacuteonset of parkinsonism on the fourteenth day after a rapid correction of severe hyponatremia. Magnetic resonance imaging of the bilateral basal ganglia showed a high signal intensity on T2-weighted images, and a low signal on T1- weighted images. She was started on levodopa, and parkinsonian features slowly improved. We report an unusual case of EPM without CPM, that presented with parkinsonism.
Basal Ganglia ; Brain ; Female ; Gait ; Humans ; Hypokinesia ; Hyponatremia ; Levodopa ; Magnetic Resonance Imaging ; Myelinolysis, Central Pontine* ; Parkinson Disease, Secondary* ; Parkinsonian Disorders ; Scrub Typhus ; Tremor

No abstract available.
Parkinsonian Disorders*

No abstract available.
Parkinsonian Disorders