RESUMO
We describe a patient with probable dementia with Lewy bodies (DLB) whose Parkinsonism worsened after administration of rivastigmine within the therapeutic dose range. Some extrapyramidal signs (EPS) then reversed to pre-treatment level after rivastigmine dose reduction. We draw attention to the need of EPS monitoring during titration of cholinesterase inhibitors in patients with DLB. This is the first report to our knowledge of iatrogenic worsening of Parkinsonism which was successfully managed by dose reduction.
Assuntos
Acetilcolina/metabolismo , Inibidores da Colinesterase/administração & dosagem , Transtornos Parkinsonianos/tratamento farmacológico , Fenilcarbamatos/administração & dosagem , Idoso , Inibidores da Colinesterase/efeitos adversos , Progressão da Doença , Humanos , Doença por Corpos de Lewy/complicações , Masculino , Transtornos Parkinsonianos/etiologia , Fenilcarbamatos/efeitos adversos , Rivastigmina , Fatores de TempoRESUMO
Description of a case of probable dementia with Lewy bodies featuring parkinsonism, dementia and supranuclear gaze palsy. This is the first patient to our knowledge affected with vertical gaze palsy receiving clinical diagnosis of DLB when alive and to be treated with cholinesterase inhibitors.