Permanent dementia in idiopathic Parkinsonism treated with levodopa.

摘要: An acute confusional-hallucinatory syndrome, followed by stupor and permanent dementia occurred in a patient with mild idopathic parkinsonism receiving trihexy-phenidyl, amantadine, levodopa. During the stuporous period, his eyes were divergent, absent oculocephalic reflexes. There no abnormalities of other cranial nerve functions or long tract signs. Intravenous doses pyridoxine benefit. The electroencephalogram was diffusely slow. Results laboratory studies unremarkable, except for hydrocephalus ex vacuo. Seventeen days after onset, he began to recover from stupor, became alert but profoundly demented until death four months later. Neuropathological changes included depigmentation, neuronal loss, gliosis Lewy bodies substantia nigra, hydrocephalus, atherosclerotic basilar carotid arteries, few tiny cerebellar infarcts. Pathological did not explain illness.