パーキンソン病の幻視・体感幻覚に抑肝散で臨床的な改善がみられた症例(神経内科学教室岩田誠教授退任記念特別号)

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  • A Case Report of Parkinson's Disease, in Whom Yokukansan Was Effective on Visual Hallucination and Cenesthopathy(Special Issue in Hornor of the Retirement of Professor Makoto Iwata at the Department of Neurology, Tokyo Women's Medical University)

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Between 20% and 45% of the patient with Parkinson's disease (PD) have hallucination in their lives, and most of them are visual. We have a 68-year-old female patient with PD lasting for 20 years and she has peculiar cenesthopathy and visual hallucination. She has been taking levodopa/carbidopa, pergolide and cabergoline. Since 2004, she has had visual hallucinations of people and insects, as well as cenesthopathy that Manta ray was sticking on her back. Her consciousness was alert and she had not dementia. Single-photon emission computed tomography (SPECT) shows the decreasing uptaking of HM-PAO in left parietal robe and bilateral occipital robe. As for her treatment, we replaced the dopamine agonist cabergoline with pramipexole, in order to prevent the excessive buildup of dopamine. She also started Yokukansan at 2.5 g/day and up to 7.5 g/day. The frequency of hallucinations was reduced from 50% to 25% of the time she was awake. We concluded that Yokukansan is effectivw for hallucination in PD.

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