• Title/Summary/Keyword: secondary Parkinsonism

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Astrocytoma in the Third Ventricle and Hypothalamus Presenting with Parkinsonism

  • Choi, Kang-Ho;Choi, Seong-Min;Nam, Tai-Seung;Lee, Min-Cheol
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.144-146
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    • 2012
  • 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.

Two Cases of Drug-induced Secondary Parkinsonism Treated with Sasang Constitutional Therapy (사상처방을 활용한 약물 유발성 속발성 파킨슨증 치험 2례)

  • Jung, Sung-Kook;Song, Jeong-Mo
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.4
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    • pp.109-119
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    • 2012
  • Objectives : This study is about two patients of drug-induced secondary parkinsonism caused by antipsychotic drugs. The purpose of this study is to report the clinical effects of Sasang constitutional medicine. Methods : These two patients were treated by Sasang constitutional herbal medications based on "Donguisusebowon". We evaluated the symptoms through the score of the Unified Parkinson's Disease Rating Scale(UPDRS). Results and Conclusions : The patients' chief complaints were improved. This study shows that Sasang constitutional herbal medications are an effective treatment for drug-induced secondary parkinsonism patients, but further studies are still necessary.

A Case Report of Drug-Induced Parkinsonism Treated with Jodeung-san and Electro-acupuncture at GB34 (조등산(Diaoteng-san, Choto-san, 釣藤散)과 GB34(陽陵泉) 전침치료를 활용한 약인성파킨슨증후군 환자의 증례 1례)

  • Kim, Eun-ji;Song, Ho-joon;Kim, Hyun-ho;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.600-609
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    • 2017
  • Drug-induced Parkinsonism is the most frequently observed type among the cases of secondary Parkinsonism. Besides typical parkinsonian symptoms, such as tremor, rigidity and bradykinesia, drug-induced Parkinsonism manifests with additional simultaneous symptoms like orobuccolingual dyskinesia, mixed type of tremor (resting, action), and symmetry of expressions. We present a case of drug-induced Parkinsonism, affected by taking the antiulcer drug cimetidine. Jodeung-san extract (Choto-san, Tsumura Co. 10) was administered for 7 days and acupuncture (electronic, auricular, pharmacopuncture) was conducted 3 times. The clinical outcomes were then evaluated through the patient's global impression of change, visual analogue scale, and Hoehn and Yahr stage. After the treatment, the clinical features, such as tremor and orobuccolingual dyskinesia, disappeared. The combination of Jodeung-san and electro-acupuncture at GB34 could therefore be a remedy for the patients with drug-induced Parkinsonism.

Drug-Induced Dyskinesia Outpatient Suspected to be Induced by Risperidone Management with Yigan-san with Citri Pericarpium and Pinelliae Rhizoma (modified Yigan-san, Yokukan-san Kachimpihang), Electro-Acupuncture at GB34 (陽陵泉), and Stopping Suspected Medication: A Case Report (Risperidone으로 유발된 것으로 의심된 약물유발성 이상운동증에 대한 의심약물 중단 및 억간산가진피반하와 GB34(陽陵泉) 전침치료를 통한 외래기반 관리 : 증례보고)

  • Roh, Min-yeong;Jang, Seung-won;Kim, Hyun-ho;Han, Yang-hee;Leem, Jungtae
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1303-1310
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    • 2019
  • Objectives: Drug-induced Parkinsonism has similar symptoms to Parkinson's disease, but each has different causes. Drug-induced Parkinsonism accounts for the largest proportion of secondary Parkinsonism We report a outpatient case of drug-induced Parkinsonism after taking Risperidone, an atypical antipsychotic. Method: With discontinuing of antipsychotic drug, modified Yigan-san extract was administered for 12 weeks, and acupuncture and electroacupuncture procedures were performed 20 times. Results: Abnormal Involuntary Movement Scale (AIMS) score decreased from 23 to 3 during 59 days of treatment period without adverse events and worsening of depression. The Patient was highly satisfied. Conclusion: Modified Yigan-san and electroacupuncture (GB34) can be used as an treatment option in patients with drug-induced Parkinsonism.

A Case Report of Gait Disturbance in a Patient with Idiopathic Normal Pressure Hydrocephalus Induced by Secondary Parkinsonism Treated with Korean Medicine (보행 장애를 주소로 하는 특발성 정상압 수두증으로 인한 이차성 파킨슨증 환자의 한의치료 증례보고 1례)

  • Choi, In-woo;Yang, Ji-hye;Chae, In-cheol;Kim, Chan-young;Ryu, Ju-young;Jung, Eun-sun;Kim, Yoon-sik;Seol, In-chan;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.41 no.5
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    • pp.811-820
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    • 2020
  • Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment of a gait disturbance in a patient with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism. Methods: The patient was treated with Korean herbal medicine (Yukmijihwang-tang-gami), acupuncture, moxibustion, and rehabilitation exercise. The gait of the patient was evaluated by the 10 m Walk Test, Timed Up and Go (TUG) test, 360° turning test, Functional Ambulatory Category (FAC), and GAITRite. Results: After 20 days of traditional Korean medicine treatment, we observed improvement in the symptoms of the gait disturbance. Conclusion: Traditional Korean medicine treatment might be effective in the treatment of gait disturbance in patients with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism.

Metabolic Topography of Parkinsonism

  • Kim, Jae-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.141-151
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    • 2007
  • Parkinson's disease is one of the most frequent neurodegenerative diseases, which mainly affects the elderly. Parkinson's disease is often difficult to differentiate from atypical parkinson diorder such as progressive supranuclear palsy, multiple system atrophy, dementia with Lewy body, and corticobasal ganglionic degeneration, based on the clinical findings because of the similarity of phenotypes and lack of diagnostic markers. The accurate diagnosis of Parkinson's disease and atypical Parkinson disorders is not only important for deciding on treatment regimens and providing prognosis, but also it is critical for studies designed to investigate etiology and pathogenesis of parkinsonism and to develop new therapeutic strategies. Although degeneration of the nigrostriatal dopamine system results in marked loss of striatal dopamine content in most of the diseases causing parkinsonism, pathologic studies revealed different topographies of the neuronal cell loss in Parkisonism. Since the regional cerebral glucose metabolism is a marker of integrated local synaptic activity and as such is sensitive to both direct neuronal/synaptic damage and secondary functional disruption at synapses distant from the primary site of pathology, an assessment of the regional cerebral glucose metabolism with F-18 FDG PET is useful in the differential diagnosis of parkinsonism and evaluating the pathophysiology of parkisonism.

Clinical study on a case of a patient with a glossal tremor caused by a side effect of drugs (약물부작용(藥物副作用)으로 인한 설부(舌部) 진전환자(震顫患者) 증례보고(症例報告))

  • Kim, Geun-Woo;Koo, Byung-Soo;Kim, Hun-Il
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.1
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    • pp.133-139
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    • 2003
  • The most common and unacknowleged something in the secondary parkinsonism is parkinsonism caused by drug abuse. Patient had a glossal tremor caused by a side effect of GIT regulators and antispasmodics taked for the purpose of cured cholecystitis. We thought that the cause of a glossal tremor is 'Pungdam(風痰)' and gave 'Chukdamtang(滌痰湯)'. As a result this patient was taken a quick turn for the better. This case is specific. Because parkinsonism is caused by GIT regulators and antispasmodics, and the symptom of side effect is a glossal tremor. We hope that this case arouse people's attention to a tremor caused by a side effect of drugs and is useful to medical cure and prognosis.

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Salivary Gland Uptake on 18F-FP-CIT PET as a New Biomarker in Patients With Parkinsonism

  • Seo Young Kang;Ji Young Yun;Yeon-Koo Kang;Byung Seok Moon;Hai-Jeon Yoon;Min Young Yoo;Bom Sahn Kim
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.690-697
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    • 2023
  • Objective: 18F-FP-CIT positron emission tomography (PET) is known for its high sensitivity and specificity for evaluating striatal dopamine transporter (DAT) binding. Recently, for the early diagnose of Parkinson's disease, many researchers focused on the diagnosis of synucleinopathy in organs involved in non-motor symptoms of Parkinson's disease. We investigated the feasibility of salivary gland uptake on 18F-FP-CIT PET as a new biomarker in patients with parkinsonism. Materials and Methods: A total of 219 participants with confirmed or presumed parkinsonism, including 54 clinically diagnosed idiopathic Parkinson's disease (IPD), 59 suspected and yet undiagnosed, and 106 with secondary parkinsonism, were enrolled. The standardized uptake value ratio (SUVR) of the salivary glands was measured on both early and delayed 18F-FP-CIT PET scans using the cerebellum as the reference region. Additionally, the delayed-to-early ratio (DE_ratio) of salivary gland was obtained. The results were compared between patients with different PET patterns. Results: The SUVR in early 18F-FP-CIT PET scan was significantly higher in patients with IPD pattern compared that in the non-dopaminergic degradation group (0.5 ± 0.19 vs. 0.6 ± 0.21, P < 0.001). Compared with the non-dopaminergic degradation group, the DE_ratio was significantly lower in patients with IPD (5.05 ± 1.7 vs. 4.0 ± 1.31, P < 0.001) or atypical parkinsonism patterns (5.05 ± 1.7 vs. 3.76 ± 0.96, P < 0.05). The DE_ratio was moderately and positively correlated with striatal DAT availability in both the whole striatum (r = 0.37, P < 0.001) and posterior putamen (r = 0.36, P < 0.001). Conclusion: Parkinsonism patients with an IPD pattern exhibited a significant increase in uptake on early 18F-FP-CIT PET and a decrease in the DE_ratio in the salivary gland. Our findings suggest that salivary gland uptake of dual-phase 18F-FP-CIT PET can provide diagnostic information on DAT availability in patients with Parkinson's disease.

A Case Report of Non-Motor Symptoms Evaluated Using the Non-Motor Symptom Scale in a Patient with Secondary Parkinsonism Presumed to be Probable Lewy Body Dementia and Improved with Combined Treatment with Herbal Medicine and Acupuncture (루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례)

  • Roh, Min-yeong;Lee, Ji-hyun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.833-845
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    • 2021
  • Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.