Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Progressive Parkinsonism Three Years after Shunt Surgery in a Patient with Idiopathic Normal Pressure Hydrocephalus
Hitoshi ShimadaYasuo Shimada
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JOURNALS OPEN ACCESS

2020 Volume 59 Issue 17 Pages 2183-2186

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Abstract

An 86-year-old man, who had undergone a lumboperitoneal shunt for idiopathic normal pressure hydrocephalus (iNPH) implanted 4 years earlier showed progressive parkinsonism for the past year. His clinical symptoms, including resting tremor and rapid eye movement sleep behavior disorder, responsiveness to levodopa, and abnormal findings on 123I-meta-iodobenzylguanidine myocardial scintigraphy and dopamine transporter imaging, indicated that his pathological background of parkinsonism included concomitant synucleinopathy, such as Parkinson's disease or dementia with Lewy bodies, in addition to iNPH. Clinicians should consider the possibility of concomitant proteinopathies and their treatments when clinical symptoms become evident after shunt operations in patients with iNPH.

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© 2020 by The Japanese Society of Internal Medicine
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