Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of Parkinson's disease following dystonia

Chiharu Yasuda, M.D.1), Takanobu Takei, M.D.1), Takenori Uozumi, M.D., Ph.D.1), Tomoko Toyota, M.D., Ph.D.2), Tomoaki Yuhi, M.D., Ph.D.3) and Hiroaki Adachi, M.D., Ph.D.2)

1)Department of Neurology, University of Environmental and Occupational Health, Japan, Wakamatsu Hospital
2)Department of Neurology, University of Environmental and Occupational Health, Japan
3)Department of Neurology, Japan Labour Health and Welfare Organization, Moji Medical Center

Parkinsonism and dystonia are both disorders of the extrapyramidal motor system, and some patients exhibit a complex of the two symptoms. Although several reports have referred to the coexistence of these disorders as parkinsonian disorders with dystonia, in the majority of cases, dystonia appeared after parkinsonism. DAT-scan is useful for the early diagnosis of Parkinson's disease (PD) and other types of parkinsonism such as dementia with Lewy bodies. This case report describes a 67-year old woman diagnosed with axial dystonia without parkinsonism 6 years previously, which had worsened despite treatment with Botulinum toxin injections, and hindered the patient's gait. The patient visited the hospital because of gait disturbances and DAT-scan showed a levodopa transducer decrease in the putamen. A few weeks later, she was re-admitted to hospital and exhibited Parkinsonism. Levodopa improved the gait disturbances but axial dystonia was unchanged, and a clinical diagnosis of PD was made. In the authors' opinion, this was a rare case of parkinsonian disorders with dystonia, characterized by the development of PD after dystonia. DAT-scan may be helpful for the diagnosis of patients with parkinsonian disorders with dystonia.
Full Text of this Article in Japanese PDF (537K)

(CLINICA NEUROL, 56: 600|604, 2016)
key words: Parkinson's disease, dystonia, DAT-scan

(Received: 24-Mar-16)