Parkinson's disease without expected neuropathologic abnormality

Miodrag Velickovic, Gerson Lesser, Dushyant Purohit, Richard R. Neufeld, Chaim Y. Tarshish, Leslie S. Libow

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

A case is reported of an initially 78-year-old man whose presentation and course, closely followed over 10 years by an academic neurologist, were consistent with classic idiopathic Parkinson's disease (PD), including unilateral onset, obvious cogwheeling, and a very good prolonged response to levodopa/carbidopa (LD/CD). Yet at autopsy, there was no neuronal loss in the substantia nigra nor were there any Lewy bodies or immunochemical evidence of alpha synuclein in the multiple brain structures studied. This case does not support the hypothesis that the use of LD/CD is toxic to the substantia nigra in people. This patient had been on traditional doses of LD/CD for approximately 10 years, yet the number of cells in the substantia nigra was well within the normal range at autopsy. These findings are not unique, but point out the need to explain the occurrence of typical PD symptoms and course in the absence of any PD-related neuropathologic changes.

Original languageEnglish
Pages (from-to)407-409
Number of pages3
JournalJournal of the American Medical Directors Association
Volume5
Issue number6
DOIs
StatePublished - 2004

Keywords

  • Alzheimer's disease
  • L-dopa toxicity
  • Lewy bodies
  • Parkinson's disease

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