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Secondary Parkinsonism


Presentation

  • The cause underlying this clinical presentation was identified as the chronic pressure brought forward by the cavernous hemangioma.[ncbi.nlm.nih.gov]
  • This case report was presented before at AOPMC 2016, Manila. It has not been published yet. To cite this abstract in AMA style: D. Desai, S. Desai. Rare presentation of acute secondary parkinsonism in the post partum period. [abstract].[mdsabstracts.org]
  • Our patient presented initially with advanced extra-neural disease without neurologic symptoms.[jmedicalcasereports.biomedcentral.com]
Weakness
  • The patient returned, complaining of generalized weakness. The ED workup this time, comprising laboratory testing and computed tomography of the abdomen and pelvis, was negative. She was given a diagnosis of “cisplatin neurotoxicity.”[mdedge.com]
  • Common symptoms include: Decrease in facial expressions Difficulty starting and controlling movement Loss or weakness of movement (paralysis) Soft voice Stiffness of the trunk, arms, or legs Tremor Confusion and memory loss may be likely in secondary[salud.wikiplus.org]
  • Symptoms Common symptoms include: Decrease in facial expressions Difficulty starting and controlling movement Loss or weakness of movement (paralysis) Soft voice Stiffness of the trunk, arms, or legs Tremor Confusion and memory loss may be likely in secondary[health.firstlighthealthsystem.org]
Pain
  • A pre-parkinsonian state is recognized with insomnia, increase in violent dreams, talking, yelling in sleep. [1] [2] Olfactory dysfunction, Oral pain, akathisia, genital pain [2] These are pre-parkinsonism features and thought to be due to neuronal loss[explainmedicine.com]
  • Her primary complaints in the ED were “throbbing” in the thighs bilaterally and leg pain. The woman’s postop course had otherwise been uncomplicated.[mdedge.com]
  • Gastrointestinal symptoms, pain, urinary problems and postural instability due to orthostatic hypotension were most frequent in MSA. Sleep disturbances were also common with a prevalence of approximately 70% in all diagnostic groups but CBD (36%).[ncbi.nlm.nih.gov]
  • Case presentation A 57-year-old Caucasian man born in Spain was admitted to hospital with a two-month history of asthenia and diffuse abdominal pain that was most intense over the left flank.[jmedicalcasereports.biomedcentral.com]
  • FIND A PROVIDER FIND A LOCATION SERVICES Services Cancer Care Emergency Services Heart & Vascular Services Orthopaedics Primary Care Women's Health View All Services Offered at Beaufort Memorial Joint Pain Seminar RESERVE YOUR SEAT Prepare for Parenthood[bmhsc.org]
Polydipsia
  • He improved significantly with levodopa therapy.Psychogenic polydipsia is an important cause of hyponatraemia. Overzealous correction of hyponatraemia can be counterproductive.[ncbi.nlm.nih.gov]
  • Psychogenic polydipsia is an important cause of hyponatraemia. Overzealous correction of hyponatraemia can be counterproductive.[casereports.bmj.com]
Catatonia
  • Incorrect diagnoses of depression or catatonia delayed treatment or aggravated the problem. Acute treatment included amantadine, levodopa/carbidopa with or without selegiline, diphenhydramine, or benztropine.[ncbi.nlm.nih.gov]
  • Mutism, parkinsonism, dystonia, and catatonia have all been reported in case reports as manifestations of EPM [5].[esim.eg.net]
Altered Mental Status
  • Altered mental status, mutism, dysphagia, and sialorrhea were frequent associations.[ncbi.nlm.nih.gov]
Poor Coordination
  • […] and balance problems In its classic form, causes progressive ophthalmoparesis, starting with impairment of downward gaze Responds poorly to antiparkinsonian drugs Spinocerebellar ataxias (usually type 2 or 3) Usually first manifests with imbalance and poor[msdmanuals.com]
Lhermitte's Sign
  • Cisplatin neurotoxicity has a variety of presentations, including peripheral neuropathy, gait disturbance, autonomic neuropathy, seizures, and Lhermitte’s sign (inducible tingling or a sensation like electrical shock in the arms and legs, upon flexion[mdedge.com]
Spastic Quadriplegia
  • The central basis pontis is the most common area affected and the resulting clinical syndrome, commonly called central pontine myelinolysis, is characterized by confusion, horizontal gaze paralysis, and spastic quadriplegia.[esim.eg.net]

Workup

  • The ED workup this time, comprising laboratory testing and computed tomography of the abdomen and pelvis, was negative. She was given a diagnosis of “cisplatin neurotoxicity.” No treatment was provided.[mdedge.com]

Treatment

  • Incorrect diagnoses of depression or catatonia delayed treatment or aggravated the problem. Acute treatment included amantadine, levodopa/carbidopa with or without selegiline, diphenhydramine, or benztropine.[ncbi.nlm.nih.gov]
  • Our understanding of the pathogenic mechanisms and our treatment options are expanding at a rapid pace.[books.google.de]
  • For a more detailed description of treatment, see Parkinson's disease.[sites.magellanhealth.com]

Prognosis

  • Outlook (Prognosis) Unlike Parkinson disease, some types of secondary parkinsonism may stabilize or even improve if the underlying cause is treated. Some brain problems, such as Lewy body disease, are not reversible.[health.firstlighthealthsystem.org]
  • Outlook (Prognosis) Unlike Parkinson disease, secondary parkinsonism may stabilize or even improve if the underlying cause is treated. Brain problems, such as Lewy body disease, are not reversible.[irmcphysicians.com]
  • Outlook (Prognosis) Unlike Parkinson disease, some types of secondary parkinsonism may stabilize or even improve if the underlying cause is treated. Brain problems, such as Lewy body disease, are not reversible.[stelizabeth.com]

Etiology

  • Etiologies included hypoxic-ischemic encephalopathy; haloperidol treatment with and without neuroleptic malignant syndrome; toxicity of cytosine arabinoside, cyclophosphamide, amphotericin B, and methotrexate; St.[ncbi.nlm.nih.gov]
  • However, a wide range of other etiologies may lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of neurological conditions other than Parkinson's.[icd.codes]
  • UMAE Centro Médico Nacional de Occidente; Movement Disorders Clinic, Neurology at IMSS Click here for Patient Education Secondary parkinsonism refers to a group of disorders that have features similar to those of Parkinson disease but have a different etiology[msdmanuals.com]
  • Etiology Classification Earlier disease onset type : onset 55 years Tremor dominant type : onset 55 years with tremor as sole initial (or generally predominating) symptom Non-tremor dominant type : onset 55 years with predominating bradykinesia / rigidity[amboss.com]
  • Parkinson disease in twins: an etiologic study. JAMA. 1999 Jan 27. 281(4):341-6. [Medline]. Polymeropoulos MH, Lavedan C, Leroy E, Ide SE, Dehejia A, Dutra A, et al.[emedicine.medscape.com]

Epidemiology

  • Author information 1 Dipartimento di Scienze Neurologiche, Sapienza Università di Roma, Rome, Italy. carlo.colosimo@uniroma1.it Abstract The PRIAMO study is a cross-sectional longitudinal observational study aimed at describing epidemiology and evolution[ncbi.nlm.nih.gov]
  • Parkinson's disease : parkinsonism for which no cause can be determined ( idiopathic ) References: [1] [2] Epidemiology References: [1] [1] [3] [4] [5] [6] [7] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology and etiology of Parkinson's disease: a review of the evidence. Eur J Epidemiol. 2011 Jun. 26 Suppl 1:S1-58. [Medline]. Anderson P. More Evidence Links Pesticides, Solvents, With Parkinson's. Medscape Medical News. Available at .[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Furthermore, they illustrate the metabolic effects related to acute focal lesions of the SN as opposed to the progressive degeneration in idiopathic PD and may serve to help unravel the complicated pathophysiology underlying these conditions.[ncbi.nlm.nih.gov]
  • Clinical expressions, postulated pathophysiological mechanisms and responsiveness to antiparkinson medication represent differences between IPD and secondary Parkinsonism (SP). OBJECTIVES: To evaluate NMS expressions in IPD, SP and a control group.[clinicaltrials.gov]
  • The pathophysiology is thought to be due to degeneration of a subgroup of midbrain (A8) neurons, as this area is spared in Parkinson patients not having the tremor. [1] [2] Slowness in movements [1] [2] [5] This is a core symptom and usually seen in disorders[explainmedicine.com]
  • In this article, the author discusses phenomenology, pathophysiology, diagnosis, and treatment.[medlink.com]
  • Biology of Parkinson's disease: pathogenesis and pathophysiology of a multisystem neurodegenerative disorder. Dialogues Clin Neurosci. 2004 Sep; 6(3): 259–280. Gazewood JD, Richards DR, Clebak K. Parkinson disease: an update.[parkinsonsdisease.net]

Prevention

  • People taking medicines that can cause secondary parkinsonism should be carefully monitored by the provider to prevent the condition from developing.[health.firstlighthealthsystem.org]
  • People taking medicines that can cause secondary parkinsonism should be carefully monitored by the doctor to prevent the condition from developing. References Lang AE. Parkinsonism. In: Goldman L, Schafer AI.[irmcphysicians.com]
  • Treating underlying conditions, such as stroke or infections, can reduce symptoms or prevent the condition from getting worse. If symptoms make it hard to do everyday activities, the provider may recommend medicine.[stelizabeth.com]

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