Reversal of head drop after discontinuation of olanzapine in a DLB patient.
We present a 72-year-oldpatient with probable diffuse Lewy body disease and visual hallucinations, who developed subacute reversible "dropped head syndrome" and parkinsonian signs after the introduction of olanzapine at a total daily dose of 10 mg. One week after olanzapine was withdrawn, the patient's posture started to improve. Further improvement was achieved after dopaminergic substitution. Clinical and electrophysiological observations might indicate neck extensor myopathy due to axial rigidity or focal neck dystonia, induced by dopamine receptor blockade.
Aries
Marcel J H
MJ
Department of Neurology and Memory Clinic, ZNA-Middelheim and ZNA-Hoge Beuken, Antwerp, Belgium.
Debruyne
Hans
H
Engelborghs
Sebastiaan
S
Le Bastard
Nathalie
N
Somers
Nore
N
Gorissen
Dagmar
D
Pickut
Barbara A
BA
De Deyn
Peter Paul
PP
D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D018492:Dopamine Antagonists / Q000627:therapeutic use; D005260:Female; D006212:Hallucinations / Q000150:complications / Q000188:drug therapy; D019416:Head Movements / Q000187:drug effects*; D006801:Humans; D007738:Kyphosis / Q000188:drug therapy / Q000209:etiology*; D020961:Lewy Body Disease / Q000150:complications / Q000188:drug therapy*; D009135:Muscular Diseases / Q000188:drug therapy / Q000209:etiology; D000077152:Olanzapine
D014150:Antipsychotic Agents; D018492:Dopamine Antagonists; D001569:Benzodiazepines; D000077152:Olanzapine