Levodopa-nonresponsive Lewy body parkinsonism: clinicopathologic study of two cases.
We report two patients with a primarily akinetic form of parkinsonism who were nonresponsive to treatment with levodopa. At autopsy, both patients had many Lewy bodies in brainstem and diencephalic nuclei, with sparse Lewy bodies in association cortices and more numerous Lewy bodies in the limbic cortices, consistent with the transitional form of Lewy body disease. These cases emphasize that (1) Lewy body Parkinson's disease cannot be excluded on the basis of atypical presentation or levodopa nonresponsiveness, and (2) the clinicopathologic spectrum of Lewy body disease is varied.
Mark
M H
MH
Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903.
Sage
J I
JI
Dickson
D W
DW
Schwarz
K O
KO
Duvoisin
R C
RC
D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007980:Levodopa / Q000627:therapeutic use*; D016631:Lewy Bodies / Q000737:chemistry / Q000473:pathology*; D008125:Locus Coeruleus / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D013378:Substantia Nigra / Q000737:chemistry / Q000473:pathology
D007980:Levodopa