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Fulltext Delayed parkinsonism following high mountain climbing: a case report

Hur, Tae Hun, Kim, Hyung Jun, Choi, Yun Im, Jeong, Du Shin, Park, Hyung Kook, Yang, Kwang Ik

Neurology Asia, 2013;18(1):99-101.
MyJurnal

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.

Matched MeSH terms: Globus Pallidus
Fulltext Detailed Anatomical Volumetric Study of Deep Nuclei of Brain and Other Structures Between Parkinson's Disease Patients Who Had Deep Brain Stimulation and Control Group

Goh CH, Abdullah JY, Idris Z, Ghani ARI, Abdullah JM, Wong ASH, et al.

Malays J Med Sci, 2020 May;27(3):53-60.
PMID: 32684806 DOI: 10.21315/mjms2020.27.3.6

Background: Deep brain stimulation (DBS) was pioneered by Neuroscience team of Hospital Universiti Sains Malaysia (HUSM) nearly a decade ago to treat advanced medically refractory idiopathic Parkinson's disease (IPD) patients.
Objectives: Brain volume reduction occurs with age, especially in Parkinson plus syndrome or psychiatric disorders. We searched to define the degree of volume discrepancy in advanced IPD patients and correlate the anatomical volumetric changes to motor symptoms and cognitive function.
Methods: We determined the magnetic resonance imaging (MRI)-based volumetry of deep brain nuclei and brain structures of DBS-IPD group and matched controls.
Results: DBS-IPD group had significant deep nuclei atrophy and volume discrepancy, yet none had cognitive or psychobehavioural disturbances. Globus pallidus volume showed positive correlation to higher mental function.
Conclusion: The morphometric changes and clinical severity discrepancy in IPD may imply a more complex degenerative mechanism involving multiple neural pathways. Such alteration could be early changes before clinical manifestation.

Matched MeSH terms: Globus Pallidus
Fulltext Delayed neuropsychiatric sequelae of carbon monoxide poisoning: a case report

Nurul Azreen Hashim, Norley Shuib, Salina Mohamed, Ling SL, Khariah Mat Nor

Journal of Clinical and Health Sciences, 2016;1:64-68.

Delayed neuropsychiatric sequelae is an important condition which commonly occur during recovery from acute carbon monoxide poisoning. Typical presentation would be apathy, disorientation, amnesia, hypokinesia, bizarre behavior, insomnia and neurological manifestations such as gait disturbance, hypertonia and tremor. We report here a case of a man presented with delayed neuropsychiatric sequelae one month after the carbon monoxide poisoning in his suicidal attempt. He presented with the typical presentation and diagnosis confirmed with the MRI findings. His MRI showed abnormal signal in subcortical hemisphere white matter of both temporo-fronto-parietal-occipital regions along the insula and both globus pallidus. He was treated with Olanzapine, Fluvoxamine, Chlorpromazine and Levodopa and his condition slowly improved. It is important for clinicians to recognize the symptoms and risk factors to develop delayed neuropsychiatric sequelae in patients who previously had carbon monoxide poisoning.

Matched MeSH terms: Globus Pallidus

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