Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt
BackgroundParkinsonism and akinetic mutism (AM) following ventriculo-peritoneal shunt (VPS) without underdrainage used to be considered rare, but may be underdiagnosed in daily clinical practice. Although the pathophysiology is still unclear, in several case reports, the parkinsonism and AM after VP...
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| Format: | Article |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1184713/full |
| _version_ | 1797813632215547904 |
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| author | Ying Zhang Ping Li Jifeng Zhang Chunyang Li Peng Sun Fujun Li Zhuomin Jiao |
| author_facet | Ying Zhang Ping Li Jifeng Zhang Chunyang Li Peng Sun Fujun Li Zhuomin Jiao |
| author_sort | Ying Zhang |
| collection | DOAJ |
| description | BackgroundParkinsonism and akinetic mutism (AM) following ventriculo-peritoneal shunt (VPS) without underdrainage used to be considered rare, but may be underdiagnosed in daily clinical practice. Although the pathophysiology is still unclear, in several case reports, the parkinsonism and AM after VPS shows responsiveness to dopaminergic treatment.Case presentationWe report a 19-year-old male that presented with severe parkinsonism and AM after VPS. Meanwhile, 18F-FDG-PET showed a cortical and subcortical hypometabolism. Fortunately, levodopa dramatically improved patient's symptoms and brain hypometabolism. This report provides support for the possibility that dopamine deficiency inhibits brain metabolism, and further elucidates the pathogenesis of parkinsonism and AM.ConclusionThis report highlights the presentation of a treatable parkinsonism and points out that Levodopa and/or dopamine agonist should be the first choice if the patients develop parkinson-like symptoms after VPS. |
| first_indexed | 2024-03-13T07:55:38Z |
| format | Article |
| id | doaj.art-fb9b12c9c85c48ed985e3edf21ac2e6a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T07:55:38Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fb9b12c9c85c48ed985e3edf21ac2e6a2023-06-02T05:55:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-06-011410.3389/fneur.2023.11847131184713Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shuntYing Zhang0Ping Li1Jifeng Zhang2Chunyang Li3Peng Sun4Fujun Li5Zhuomin Jiao6Department of Neurology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, ChinaDepartment of Radiology and Nuclear Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Radiology and Nuclear Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of General Surgery, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, ChinaDepartment of Neurology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, ChinaBackgroundParkinsonism and akinetic mutism (AM) following ventriculo-peritoneal shunt (VPS) without underdrainage used to be considered rare, but may be underdiagnosed in daily clinical practice. Although the pathophysiology is still unclear, in several case reports, the parkinsonism and AM after VPS shows responsiveness to dopaminergic treatment.Case presentationWe report a 19-year-old male that presented with severe parkinsonism and AM after VPS. Meanwhile, 18F-FDG-PET showed a cortical and subcortical hypometabolism. Fortunately, levodopa dramatically improved patient's symptoms and brain hypometabolism. This report provides support for the possibility that dopamine deficiency inhibits brain metabolism, and further elucidates the pathogenesis of parkinsonism and AM.ConclusionThis report highlights the presentation of a treatable parkinsonism and points out that Levodopa and/or dopamine agonist should be the first choice if the patients develop parkinson-like symptoms after VPS.https://www.frontiersin.org/articles/10.3389/fneur.2023.1184713/fullparkinsonismventriculo-peritoneal shunt18F fluorodeoxyglucoseakinetic mutismlevodopa |
| spellingShingle | Ying Zhang Ping Li Jifeng Zhang Chunyang Li Peng Sun Fujun Li Zhuomin Jiao Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt Frontiers in Neurology parkinsonism ventriculo-peritoneal shunt 18F fluorodeoxyglucose akinetic mutism levodopa |
| title | Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt |
| title_full | Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt |
| title_fullStr | Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt |
| title_full_unstemmed | Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt |
| title_short | Case report: Levodopa-responsive parkinsonism with akinetic mutism after ventriculo-peritoneal shunt |
| title_sort | case report levodopa responsive parkinsonism with akinetic mutism after ventriculo peritoneal shunt |
| topic | parkinsonism ventriculo-peritoneal shunt 18F fluorodeoxyglucose akinetic mutism levodopa |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1184713/full |
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