Epilepsy, Parkinsonism, and Neuroleptic Malignant Syndrome in a Child

A 9-year-old girl with akinetic-rigid parkinsonism with tremor is described. She was hospitalized with neuroleptic malignant syndrome that started 3 days after anticonvulsant drug treatment owing to epileptic seizures. Cranial magnetic resonance imaging (MRI) was normal, and during the follow-up, ma...

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Bibliographic Details
Published in:Journal of child neurology 2006-12, Vol.21 (12), p.1073-1075
Main Authors: Martínez, Héctor R., Cantú-Martínez, Leonel, González, Humberto C., Flores, Laura de León, Villarreal, Héctor J., Onofre-Castillo, Javier
Format: Article
Language:English
Subjects:
Anticonvulsants - adverse effects
Antiparkinson Agents - therapeutic use
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Basal Ganglia - drug effects
Basal Ganglia - metabolism
Basal Ganglia - physiopathology
Benzothiazoles - therapeutic use
Carbamazepine - therapeutic use
Child
Electroencephalography
Epilepsy - drug therapy
Epilepsy, Complex Partial - chemically induced
Epilepsy, Complex Partial - physiopathology
Female
Humans
Magnetic Resonance Spectroscopy
Neuroleptic Malignant Syndrome - diagnosis
Neuroleptic Malignant Syndrome - physiopathology
Parkinsonian Disorders - chemically induced
Parkinsonian Disorders - diagnosis
Parkinsonian Disorders - physiopathology
Phenytoin - adverse effects
Time
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Summary:A 9-year-old girl with akinetic-rigid parkinsonism with tremor is described. She was hospitalized with neuroleptic malignant syndrome that started 3 days after anticonvulsant drug treatment owing to epileptic seizures. Cranial magnetic resonance imaging (MRI) was normal, and during the follow-up, magnetic resonance spectroscopy revealed a decrement on N-acetylaspartate in the basal ganglia, suggesting neuronal dysfunction. The basal ganglia and dopamine are involved in the pathophysiology of parkinsonism and neuroleptic malignant syndrome and have been recognized in seizure propagation and seizure threshold. Parkinsonism in children is considered an acquired, secondary, and reversible disorder with a dramatic improvement to treatment. However, our patient still has parkinsonism 2 years after diagnosis. This case represents the unusual presentation of epilepsy, parkinsonism, and neuroleptic malignant syndrome, which might have a common pathophysiologic pathway (dopaminergic dysfunction) involving the basal ganglia and the hypothalamus.
ISSN:0883-0738
1708-8283
DOI:10.1177/7010.2006.00234