ABSTRACT
We describe a patient with probable dementia with Lewy bodies (DLB) whose Parkinsonism worsened after administration of rivastigmine within the therapeutic dose range. Some extrapyramidal signs (EPS) then reversed to pre-treatment level after rivastigmine dose reduction. We draw attention to the need of EPS monitoring during titration of cholinesterase inhibitors in patients with DLB. This is the first report to our knowledge of iatrogenic worsening of Parkinsonism which was successfully managed by dose reduction.
Subject(s)
Acetylcholine/metabolism , Cholinesterase Inhibitors/administration & dosage , Parkinsonian Disorders/drug therapy , Phenylcarbamates/administration & dosage , Aged , Cholinesterase Inhibitors/adverse effects , Disease Progression , Humans , Lewy Body Disease/complications , Male , Parkinsonian Disorders/etiology , Phenylcarbamates/adverse effects , Rivastigmine , Time FactorsABSTRACT
Description of a case of probable dementia with Lewy bodies featuring parkinsonism, dementia and supranuclear gaze palsy. This is the first patient to our knowledge affected with vertical gaze palsy receiving clinical diagnosis of DLB when alive and to be treated with cholinesterase inhibitors.
