Discontinuation of neuroleptic drugs led to complete remission of clinical manifestations in two patients with drug-induced parkinsonism who had histologic abnormalities characteristic of idiopathic paralysis agitans.
Case Report (n=2)
Does discontinuation of neuroleptic drugs reverse parkinsonism in patients with underlying preclinical idiopathic paralysis agitans?
Reversibility of drug-induced parkinsonism does not exclude the presence of subclinical idiopathic paralysis agitans.
Parkinsonism developed in two patients who were received neuroleptic drugs. In each case the clinical manifestations remitted completely when the offending drug or drugs were discontinued. Histologic examination in each patient disclosed abnormalities characteristic of idiopathic paralysis agitans (IPA). Levels of homovanillic acid were low in both cases, and dopamine (DA) levels were measurably reduced in the striatum in one case. It is postulated that before administration of neuroleptic drugs, both patients had preclinical IPA, which predisposed them to parkinsonism when challenged with DA antagonists. Our observations suggest that some patients with irreversible drug-induced parkinsonism may suffer from IPA and that the reversibility of clinical features does not exclude the presence of subclinical IPA.
Ali H. Rajput (1982) conducted a case report in Drug-induced parkinsonism (n=2). Discontinuation of neuroleptic drugs was evaluated on Remission of clinical manifestations and histologic examination. Discontinuation of neuroleptic drugs led to complete remission of clinical manifestations in two patients with drug-induced parkinsonism who had histologic abnormalities characteristic of idiopathic paralysis agitans.