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药物性帕金森综合征:厨房里厨师太多了。

Drug-Induced Parkinsonism: Too Many Cooks in the Kitchen.

作者信息

Liotta Mark, Bell Harrison, Vu Anh-Thu, Stillman Michael

机构信息

Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, USA.

Neurology, Thomas Jefferson University Hospital, Philadelphia, USA.

出版信息

Cureus. 2023 Sep 8;15(9):e44896. doi: 10.7759/cureus.44896. eCollection 2023 Sep.

Abstract

Drug-induced parkinsonism (DIP) is a condition characterized by the development of parkinsonian symptoms as a result of medication use. It is often misdiagnosed and can be challenging to differentiate from Parkinson's disease (PD). In this case presentation, we describe the clinical course of a 64-year-old male who presented with parkinsonian symptoms while using atypical antipsychotics, which was originally misdiagnosed as PD. The case highlights the importance of recognizing the potential iatrogenic effects of medications with antidopaminergic properties, such as antipsychotics and antiepileptic drugs, which are common culprits in causing DIP. We discuss DIP management, long-term impacts, and differentiating DIP from PD through clinical findings and imaging, emphasizing the utility of the (123)I-ioflupane single-photon emission computerized tomography (SPECT) scan in aiding diagnosis. This case serves as a reminder to healthcare providers to remain vigilant in monitoring patients for adverse effects, polypharmacy, and harmful medication interactions.

摘要

药物性帕金森综合征(DIP)是一种由于用药而出现帕金森症状的疾病。它常被误诊,且与帕金森病(PD)进行鉴别具有挑战性。在本病例报告中,我们描述了一名64岁男性的临床病程,该患者在使用非典型抗精神病药物时出现帕金森症状,最初被误诊为PD。该病例突出了认识具有抗多巴胺能特性药物(如抗精神病药物和抗癫痫药物,它们是导致DIP的常见原因)潜在医源性影响的重要性。我们讨论了DIP的管理、长期影响,以及通过临床发现和影像学将DIP与PD进行鉴别,强调了(123)I-碘氟潘单光子发射计算机断层扫描(SPECT)在辅助诊断中的作用。该病例提醒医疗服务提供者要时刻警惕监测患者的不良反应、多重用药和有害的药物相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f525/10560449/28eed2c1e8c8/cureus-0015-00000044896-i01.jpg

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