Parkinson's disease with paroxysmal breath holding and hypoxemia as the manifestation of dyskinesia: a case report / 中华神经科杂志

ABSTRACT

Parkinson's drug-induced dyskinesia is a common complication after levodopa treatment,and its clinical manifestations are complex.A case of Parkinson's L-dopa-induced dyskinesia misdiagnosed as epilepsy in our hospital is reported.The patient,a 69-year-old male,was hospitalized on May 2,2018 due to "15 years of retardation,recurrent limb twitching with breathing for more than 6 months,sudden loss of consciousess for 10 minutes".The patient took madopar for a long time and had obvious drug complications.In July 2017,the use of rasagiline improved manifestations slightly.In November 2017,repeated limb twitches began to occur.The onset time ranged from several minutes to one hour,and there was a gradual occurrence of twitching accompanied by obvious breathing.On May 1,2018,the patient was sent to our hospital for emergency treatment after limb twitching again.Due to the long-term history of hormone use,and tranquilizers and antiepileptic drugs were used to control the condition of the patient,the patient was misdiagnosed as epilepsy at first.With the adjustment of drugs and the change of condition,the patient was finally diagnosed as Parkinson's L-dopa-induced dyskinesia.The clinical manifestations of the disease include peak dyskinesia,bipolar dyskinesia and dystonia.The pathogenesis of Parkinson's disease is not completely clear and its clinical manifestations are diverse.However,there are few reports of Parkinson's disease,whose manifestation is loss of consciousness due to paroxysmal breath holding and hypoxemia.Therefore,in order to diagnose epilepsy in patients with Parkinson's disease,the possibility of dyskinesia should be excluded first.Therefore,the rational use of drugs is particularly important in the middle and late period of Parkinson's disease.