Successful antiparkinsonian medication withdrawal in patients with Parkinsonism and normal FP-CIT SPECT.
Between 4% and 14% of patients diagnosed with Parkinson's disease and entering clinical trials have normal presynaptic dopaminergic imaging. The effects of antiparkinsonian therapy have varied in these studies, and the consequences of stopping treatment are not reported. We present 11 patients who initially fulfilled diagnostic criteria and were treated for Parkinson's disease but in whom emerging diagnostic doubts led to antiparkinsonian therapy withdrawal, which was achieved without deterioration. Such cases represent a nondegenerative form of Parkinsonism, which does not benefit from dopaminergic therapy. Prospective vigilance regarding this category is of importance in clinical practice and clinical trials.
Marshall
Vicky L
VL
Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom. v.marshall@clinmed.gla.ac.uk
Patterson
Jim
J
Hadley
Donald M
DM
Grosset
Katherine A
KA
Grosset
Donald G
DG
D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
D000978:Antiparkinson Agents; D007457:Iodine Radioisotopes; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane