Recent studies suggest that impulse control disorders (ICD) in Parkinson disease are not uncommon, and antiparkinsonian therapy, mainly the use of dopaminergic agonists, plays a causal role in the development of these symptoms.... more
Recent studies suggest that impulse control disorders (ICD) in Parkinson disease are not uncommon, and antiparkinsonian therapy, mainly the use of dopaminergic agonists, plays a causal role in the development of these symptoms. Pramipexole has been mainly related to the occurrence of ICDs, although these disorders may occur when any dopaminergic agonist-based therapy is administered.In this paper, we describe 4 patients with Parkinson disease and 1 with multisystem atrophy who presented a history (several months or years) of pathological gambling, hypersexuality, punding, and pathological use of the Internet secondary to piribedil. This previously undescribed association suggests that the development of these disorders might be also related to piribedil administration. It is also the first report of a patient with multisystem atrophy developing such adverse effects.
Research Interests: Psychology, Medicine, Humans, Impulse Control Disorders, Female, and 12 moreMale, Hypersexuality, Aged, Middle Aged, Impulse Control, Neurosciences, Parkinson Disease, Pathological, Severity of Illness Index, Psychiatric Status Rating Scales, dopaminergic, and Pharmacology and pharmaceutical sciences
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Research Interests:
We describe a 73-year-old female patient with Parkinson disease who developed impulse control disorders (ICDs) and dopamine dysregulation syndrome (DDS) owing to piribedil overdose. She was initially put on piribedil 150 mg; and owing to... more
We describe a 73-year-old female patient with Parkinson disease who developed impulse control disorders (ICDs) and dopamine dysregulation syndrome (DDS) owing to piribedil overdose. She was initially put on piribedil 150 mg; and owing to disease progression, levodopa was added 4 years later. Three years later, piribedil was raised to 200 mg; but presumably owing to a misunderstanding, she took 400 mg/d, which was well tolerated and produced an improvement in her parkinsonian symptoms.However, over the next few weeks, she started shopping compulsively, buying unnecessary clothes and food. In addition, she visited her dog's veterinarian several times a day with nonsense queries. She began to have financial problems and family disruption. During an examination, mild dyskinesia was evident.We diagnosed ICDs and most likely dopamine dysregulation syndrome DDS. Piribedil doses were decreased to 200 mg/d and levodopa increased up to 750 mg/d, with a clear improvement in compulsive behavior without worsening of the dyskinesia.Our case shows that even in cases in which regular doses of dopamine agonists are harmless, dose increments can induce these unwanted effects.
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INTRODUCTION Holmes tremor (HT) is a rare condition characterized by low frequency tremor present at rest, posture and action, usually secondary to a structural lesion in the brainstem, cerebellum or thalamus. AIMS To describe the... more
INTRODUCTION Holmes tremor (HT) is a rare condition characterized by low frequency tremor present at rest, posture and action, usually secondary to a structural lesion in the brainstem, cerebellum or thalamus. AIMS To describe the clinical symptoms, etiology, neuroimaging findings and response to treatment in a series of twenty patients with HT. METHODS A retrospective study was performed, based on review of medical records and videos from the patients with diagnosis of HT in 4 neurological centers. RESULTS Thirteen women and seven men were selected, with an average age at the moment of the development of HT of 30.6 ±18.4 years (range 8-64). The most common etiologies were ischemic or hemorrhagic vascular lesions (55 [percnt]) and traumatic brain injury (20 [percnt]). The median latency from the lesion to the onset of tremor was 3.6 months, except in three patients in whom it couldn’t be determined due to the etiologies. The most common associated symptoms were motor (65 [percnt]), ...
Research Interests: Psychology and Neurology
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An 81-year-old female patient with a 12-year history of lingual pain associated to tongue and jaw involuntary movements secondary to long-term neuroleptic intake was observed. She received several pharmacological therapies without major... more
An 81-year-old female patient with a 12-year history of lingual pain associated to tongue and jaw involuntary movements secondary to long-term neuroleptic intake was observed. She received several pharmacological therapies without major improvement or side effects. Treatment with botulinum toxin type A markedly benefited both pain and lingual dyskinesia.
Research Interests:
Research Interests:
Recent studies suggest that impulse control disorders (ICD) in Parkinson disease are not uncommon, and antiparkinsonian therapy, mainly the use of dopaminergic agonists, plays a causal role in the development of these symptoms.... more
Recent studies suggest that impulse control disorders (ICD) in Parkinson disease are not uncommon, and antiparkinsonian therapy, mainly the use of dopaminergic agonists, plays a causal role in the development of these symptoms. Pramipexole has been mainly related to the occurrence of ICDs, although these disorders may occur when any dopaminergic agonist-based therapy is administered.In this paper, we describe 4 patients with Parkinson disease and 1 with multisystem atrophy who presented a history (several months or years) of pathological gambling, hypersexuality, punding, and pathological use of the Internet secondary to piribedil. This previously undescribed association suggests that the development of these disorders might be also related to piribedil administration. It is also the first report of a patient with multisystem atrophy developing such adverse effects.