ABSTRACT
We report a rare and unique presentation of a patient with early and levodopa-responsive Parkinson’s disease (PD) who exhibited clinical features similar to posterior cortical atrophy (PCA). The imaging evidence suggested the coexistence of PD and PCA, without the presence of amyloid pathology. Although the present case lacks pathologic evidence, this case represents a distinct manifestation of PD characterized by a combination of parkinsonism and early prominent posterior cognitive deficits, reminiscent of the visual variant of Alzheimer’s disease.
ABSTRACT
OBJECTIVE: Impulse control disorders (ICDs) in Parkinson's disease (PD) are mostly related to dopamine replacement therapy (DRT); however, drug-naïve PD patients have also frequently experienced impulsivity. This phenomenon makes clinicians hesitate treating patients with DRT. In this study, we assessed the effect of impulsivity on quality of life (QOL) in drug-naïve PD patients. METHODS: Two hundred three newly diagnosed, nonmedicated PD patients were enrolled, and they received structured clinical interviews, physical examinations and validated questionnaires to evaluate motor and nonmotor symptoms and QOL. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). RESULTS: Thirty-eight patients (18.7%) had impulsivity with QUIP-RS scores ≥ 1 and 4 patients (2.0%) were diagnosed with combined ICDs. Motor and nonmotor symptoms were significantly correlated with the Parkinson's Disease Questionnaire-39 summary index. Female sex and QUIP-RS scores were also correlated with QOL in drug-naïve PD patients. CONCLUSION: The results of the present study showed that impulsivity negatively influences QOL in early drug-naïve PD patients. In addition, more severe motor and nonmotor symptoms were also associated with lower QOL. Such findings complicate treatment but provide valuable information for managing early PD.
Subject(s)
Female , Humans , Disruptive, Impulse Control, and Conduct Disorders , Dopamine , Impulsive Behavior , Parkinson Disease , Physical Examination , Quality of LifeABSTRACT
No abstract available.
Subject(s)
Humans , Disorders of Excessive Somnolence , Metoclopramide , Parkinsonian DisordersABSTRACT
We report a 62-year-old woman with a simultaneous occurrence of posterior reversible encephalopathy syndrome (PRES) and Guillain-Barre syndrome (GBS). The simultaneous presence of PRES in GBS is unusual and can easily escape recognition, with potentially serious consequences for the patient. Previous reports showed that the simultaneous or initial manifestation of PRES in GBS is more common in elderly female. The preponderance of female in older age may be due to age and gender related difference in sympathetic nerve activity.