title: Multiple sclerosis exceptionally presenting as parkinsonism responds to intravenous methylprednisolone.
abstract: Parkinsonism due to multiple sclerosis (MS) is rare. In previously reported patients with MS-induced parkinsonism, MS manifested first, followed a typical clinical course, and parkinsonism developed later in the course of the illness. We report a 52-year-old male presenting with parkinsonism as the initial manifestation of MS, in whom a subsequent MS relapse consisted of marked deterioration in parkinsonism, a clinical pattern not previously described in MS. A brain MRI demonstrated involvement of the substantia nigra and basal ganglia. This patient illustrates that the clinical presentation and progression of MS may rarely be characterised by predominating parkinsonian features which are reversible by treatment with intravenous methylprednisolone and interferon beta1a.
authors.affiliation: Department of Neurology, Mercy University Hospital, Grenville Place, Cork, Ireland. shivsaidha@physicians.ie <shivsaidha@physicians.ie>
authors.forename: S
authors.initials: S
authors.lastname: Saidha
authors.forename: T H
authors.initials: TH
authors.lastname: Mok
authors.forename: M
authors.initials: M
authors.lastname: Butler
authors.forename: N
authors.initials: N
authors.lastname: Fanning
authors.forename: H
authors.initials: H
authors.lastname: Harrington
mesh_terms: D018450:Disease Progression; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy*; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone