Abstract
We report on a patient with genetically proven Machado-Joseph Disease (MJD) presenting with signs indistinguishable from Parkinson's disease (PD), including levodopa response and typical levodopa-induced motor fluctuations. Only after 10 years of prolonged benefit from levodopa and different dopamine agonists (DA), the patient developed cerebellar ataxia and pyramidal signs. Preferential D3-receptor-stimulating dopamine agonists especially showed a benefit at the time, when D2 receptor binding was reduced in IBZM SPECT. This is the first report of a meaningful response to DA in MJD.
Copyright 2002 Movement Disorder Society
MeSH terms
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Atrophy / pathology
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Basal Ganglia / pathology
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Benzamides / pharmacokinetics
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Cerebellum / pathology
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Contrast Media
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Corpus Striatum / metabolism
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Dopamine Agonists / therapeutic use*
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Humans
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Machado-Joseph Disease / complications
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Machado-Joseph Disease / genetics*
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Occipital Lobe / metabolism
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Parkinsonian Disorders / drug therapy*
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Parkinsonian Disorders / etiology
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Parkinsonian Disorders / genetics*
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Phenotype
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Pons / pathology
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Pyrrolidines / pharmacokinetics
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Tomography, Emission-Computed, Single-Photon
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Treatment Outcome
Substances
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Benzamides
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Contrast Media
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Dopamine Agonists
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Pyrrolidines
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3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide