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Rapidly Progressive Parkinsonism that Developed One Year after Ventriculoperitoneal Shunting for Idiopathic Aqueductal Stenosis: A Case Report Takeo Sakurai 1 , Akio Kimura 1 , Megumi Yamada 1 , Yuichi Hayashi 1 , Yuji Tanaka 1 , Isao Hozumi 1 , Takashi Inuzuka 1 1Department of Neurology and Geriatrics,Division of Neuroscience,Research Field of Medical Sciences,Gifu University Graduate School of Medicine Keyword: parkinsonism , ventriculoperitoneal shunt , idiopathic aqueductal stenosis , fluorodopa-positron emission tomography , levodopa pp.527-531
Published Date 2010/5/1
DOI https://doi.org/10.11477/mf.1416100685
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Abstract

 A 46-year-old woman was diagnosed with having idiopathic aqueductal stenosis for which she underwent ventriculoperitoneal (V-P) shunting. One year after the surgery, she developed acute parkinsonism and sylvian aqueduct syndrome. Brain magnetic resonance imaging (MRI) did not reveal any signs of hydrocephalus and fluorodopa positron emission tomography (PET) did not reveal any decrease in accumulation of fluorodopa at the striatum. On admission, the Unified Parkinson Disease Rating Scale (UPDRS) (Part III) score was 30 points. The preliminary diagnosis was parkinsonism associated with V-P shunting: therefore, the levodopa dosage was increased from 200mg/day to 600mg/day. Thereafter, the symptoms of parkinsonism and the sylvian aqueduct syndrome markedly improved, and the UPDRS (Part III) score decreased. If such a patient presents without signs of hydrocephalus or shunt malfunction, dopaminergic medication should be used as the initial treatment.

(Received: June 10,2009,Accepted: December 28,2009)


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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