Unilateral Parkinson's disease and contralateral tardive dyskinesia: a unique case with successful therapy that may explain the pathophysiology of these two disorders.
A unique case reported of a patient with right-sided Parkinson's disease and left-sided tardive dyskinesia. This situation occurred because the patient's parkinsonian tremor was treated with antipsychotic drugs. After several months she developed tardive dyskinesia on the left side of the body. Successful treatment was achieved nine years later, using dopamine-depleting drugs (combination reserpine and alpha-methylparatyrosine) to suppress the tardive dyskinesia and trihexyphenidyl to reduce the parkinsonism. Control of the symptoms was complicated with parkinsonism symptoms later increased on the right and developed on the left, due to the dopamine-depleting drugs. A small amount of carbidopa/levodopa restored the proper balance of symptoms, effectively reducing the parkinsonism while not aggravating the tardive dyskinesia. This unique case provides insight into the pathogeneis of Parkinson's disease, the pathogenesis of tardive dyskinesia, their successful therapeutic approaches, and possibly the effect of drugs in blocking the progression of Parkinson's disease.
D000368:Aged; D003342:Corpus Striatum / Q000503:physiopathology; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*