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Jaw tremor: a manifestation of vascular parkinsonism? - a case report

BACKGROUND: Vascular Parkinsonism (VP) is a heterogeneous group of conditions that manifest clinically in parkinsonian features, but are presumably of vascular cause. It is usually bilateral, non-tremulous, and frequently associated with pyramidal signs. Classically VP is described as lower body par...

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Autores principales: Udagedara, Thilini B., Gooneratne, Inuka Kishara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026506/
https://www.ncbi.nlm.nih.gov/pubmed/29960586
http://dx.doi.org/10.1186/s12883-018-1093-5
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author Udagedara, Thilini B.
Gooneratne, Inuka Kishara
author_facet Udagedara, Thilini B.
Gooneratne, Inuka Kishara
author_sort Udagedara, Thilini B.
collection PubMed
description BACKGROUND: Vascular Parkinsonism (VP) is a heterogeneous group of conditions that manifest clinically in parkinsonian features, but are presumably of vascular cause. It is usually bilateral, non-tremulous, and frequently associated with pyramidal signs. Classically VP is described as lower body parkinsonism affecting predominantly the legs. CASE PRESENTATION: A 67 years old lady presented with a history of acute onset jaw tremor, with tremor predominantly in both upper limbs. Neurological examination revealed hypomimia of the face with cogwheel rigidity and bradykinesia bilaterally, predominantly in the upper limbs without pyramidal signs. She had a marked tremor of the jaw at rest. When she was asked to open her mouth the tremor was re-emergent. Non contrast CT scan of her brain revealed an infarction in the region of putamen on the left with no evidence of diffuse subcortical white matter ischemia or extension to the caudate nucleus. She was treated with levodopa and responded well to medication. CONCLUSIONS: This case describes atypical clinical features which could be associated with VP including jaw tremor. This case also stresses the importance of initiating a trial of levodopa as certain patients may respond well to medication. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12883-018-1093-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-60265062018-07-09 Jaw tremor: a manifestation of vascular parkinsonism? - a case report Udagedara, Thilini B. Gooneratne, Inuka Kishara BMC Neurol Case Report BACKGROUND: Vascular Parkinsonism (VP) is a heterogeneous group of conditions that manifest clinically in parkinsonian features, but are presumably of vascular cause. It is usually bilateral, non-tremulous, and frequently associated with pyramidal signs. Classically VP is described as lower body parkinsonism affecting predominantly the legs. CASE PRESENTATION: A 67 years old lady presented with a history of acute onset jaw tremor, with tremor predominantly in both upper limbs. Neurological examination revealed hypomimia of the face with cogwheel rigidity and bradykinesia bilaterally, predominantly in the upper limbs without pyramidal signs. She had a marked tremor of the jaw at rest. When she was asked to open her mouth the tremor was re-emergent. Non contrast CT scan of her brain revealed an infarction in the region of putamen on the left with no evidence of diffuse subcortical white matter ischemia or extension to the caudate nucleus. She was treated with levodopa and responded well to medication. CONCLUSIONS: This case describes atypical clinical features which could be associated with VP including jaw tremor. This case also stresses the importance of initiating a trial of levodopa as certain patients may respond well to medication. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12883-018-1093-5) contains supplementary material, which is available to authorized users. BioMed Central 2018-06-30 /pmc/articles/PMC6026506/ /pubmed/29960586 http://dx.doi.org/10.1186/s12883-018-1093-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Udagedara, Thilini B.
Gooneratne, Inuka Kishara
Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title_full Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title_fullStr Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title_full_unstemmed Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title_short Jaw tremor: a manifestation of vascular parkinsonism? - a case report
title_sort jaw tremor: a manifestation of vascular parkinsonism? - a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026506/
https://www.ncbi.nlm.nih.gov/pubmed/29960586
http://dx.doi.org/10.1186/s12883-018-1093-5
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