Atypical dopa responsive parkinsonism in a patient with megalencephaly, midbrain Lewy body disease, and some pathological features of Hallervorden-Spatz disease

P. J. Tuite, J. P. Provias, A. E. Lang

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11 Scopus citations

Abstract

A 38 year old patient with megalencephaly, mental retardation, and lifelong tremor developed levodopa responsive parkinsonism in his mid-30s followed by the appearance of dyskinesiae, motor fluctuations, hallucinations, and dementia. Brain MRI showed, as well as other changes, iron deposition in the globus pallidus, substantia nigra, and the pulvinar of the thalamus. Postmortem examination disclosed depigmentation of the substantia nigra pars compacta with neuronal loss, gliosis, and Lewy body formation. Axonal dystrophic spheroids, neuronal loss, calcification, and iron deposition were found in the substantia nigra pars reticulata. Less severe changes without neuronal loss were seen in the globus pallidus. This combination of megalencephaly with neuroaxonal changes predominently in the pars reticulata and Lewy body degeneration isolated to the substantia nigra pars compacta has not been previously reported.

Original languageEnglish (US)
Pages (from-to)523-527
Number of pages5
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume61
Issue number5
DOIs
StatePublished - Nov 1996

Keywords

  • Dystrophic axone
  • Hallervorden-Spatz disease
  • Lewy body disease
  • Parkinsonism

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