A Case of Long-Term Exposure to Valproic Acid Mimicking Tremor-Dominant Parkinson's Disease.

IF 2.5 Q2 CLINICAL NEUROLOGY

Tremor and Other Hyperkinetic Movements Pub Date : 2023-01-01 DOI:10.5334/tohm.755

Kazumasa Sekiguchi, Toshihiro Mashiko, Reiji Koide, Kensuke Kawai, Shigeru Fujimoto, Ryota Tanaka

{"title":"A Case of Long-Term Exposure to Valproic Acid Mimicking Tremor-Dominant Parkinson's Disease.","authors":"Kazumasa Sekiguchi, Toshihiro Mashiko, Reiji Koide, Kensuke Kawai, Shigeru Fujimoto, Ryota Tanaka","doi":"10.5334/tohm.755","DOIUrl":null,"url":null,"abstract":"Background: Valproic acid is associated with increased risks of tremor and parkinsonism.Case report: A 67-year-old man with a diagnosis of epilepsy who had been treated with valproic acid (VPA) for 32 years noticed right-dominant upper-limb resting tremor accompanied by mild rigidity and bradykinesia. He was initially diagnosed with tremor-dominant Parkinson's disease (TDPD), but dopamine transporter single-photon emission computed tomography demonstrated no nigrostriatal degeneration. At 3 months after discontinuing VPA, his symptoms dramatically improved.Discussion: VPA-induced tremor usually consists of postural or kinetic tremor without asymmetry. Our case indicated that careful evaluation is needed, even in cases of asymmetrical resting tremor and mild parkinsonism resembling TDPD after long term exposure to VPA.Highlights: We report an atypical case of valproic acid-induced tremor and parkinsonism that mimics tremor-dominant Parkinson's disease. Physicians should not exclude the possible relation to valproic acid in patients presenting unilateral resting tremor and parkinsonism even in the absence of long-term side effects.","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10198224/pdf/","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tremor and Other Hyperkinetic Movements","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5334/tohm.755","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 1

Abstract

Background: Valproic acid is associated with increased risks of tremor and parkinsonism.

Case report: A 67-year-old man with a diagnosis of epilepsy who had been treated with valproic acid (VPA) for 32 years noticed right-dominant upper-limb resting tremor accompanied by mild rigidity and bradykinesia. He was initially diagnosed with tremor-dominant Parkinson's disease (TDPD), but dopamine transporter single-photon emission computed tomography demonstrated no nigrostriatal degeneration. At 3 months after discontinuing VPA, his symptoms dramatically improved.

Discussion: VPA-induced tremor usually consists of postural or kinetic tremor without asymmetry. Our case indicated that careful evaluation is needed, even in cases of asymmetrical resting tremor and mild parkinsonism resembling TDPD after long term exposure to VPA.

Highlights: We report an atypical case of valproic acid-induced tremor and parkinsonism that mimics tremor-dominant Parkinson's disease. Physicians should not exclude the possible relation to valproic acid in patients presenting unilateral resting tremor and parkinsonism even in the absence of long-term side effects.

查看原文本刊更多论文

长期接触丙戊酸诱发震颤主导型帕金森病1例

背景:丙戊酸与震颤和帕金森病的风险增加有关。病例报告:一名67岁的癫痫患者，服用丙戊酸(VPA)治疗32年，发现右上肢静息性震颤伴轻度强直和运动迟缓。他最初被诊断为震颤型帕金森病(TDPD)，但多巴胺转运体单光子发射计算机断层扫描显示没有黑质纹状体变性。停用VPA 3个月后，他的症状显著改善。讨论:vpa诱发的震颤通常由体位性或动态性震颤组成，无不对称性。我们的病例表明，即使在长期暴露于VPA后出现不对称静息性震颤和类似TDPD的轻度帕金森病，也需要仔细评估。重点:我们报告一个非典型的丙戊酸诱发的震颤和帕金森病，模拟震颤显性帕金森病。即使在没有长期副作用的情况下，医生也不应排除出现单侧静息性震颤和帕金森病的患者与丙戊酸的可能关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Tremor and Other Hyperkinetic Movements CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

4.50%

发文量

审稿时长

6 weeks