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Dementia with Lewy bodies presenting marked tongue protrusion and bite due to lingual dystonia: A case report
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- Shiga Yuji
- Department of Neurology, Brain Attack Center Ota Memorial Hospital
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- Kanaya Yuhei
- Department of Neurology, Brain Attack Center Ota Memorial Hospital
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- Kono Ryuhei
- Department of Neurology, Brain Attack Center Ota Memorial Hospital Present Address: Kin-ikyo Chuo Hospital
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- Takeshima Shinichi
- Department of Neurology, Brain Attack Center Ota Memorial Hospital
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- Shimoe Yutaka
- Department of Neurology, Brain Attack Center Ota Memorial Hospital
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- Kuriyama Masaru
- Department of Neurology, Brain Attack Center Ota Memorial Hospital
Bibliographic Information
- Other Title
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- 舌ジストニアによる著明な舌突出と咬舌を呈したレヴィ小体型認知症の1例
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Description
We report the patient of a 53-year-old woman who developed subacute-onset marked tonge protrusion and bite. She was diagnosed as dementia with Lewy bodies (DLB) from the clinical features including progressive cognitive decline, visual hallucinations, parkinsonism, and severe insomnia and depression, and the radiological finding of low dopamine transported uptake in basal ganglia by Dat SCAN and low blood circulation in occipital lobe of cerebrum. The patient received 600 mg doses of levodopa for over a year, followed by rotigotine and ropinirole with a rapid increase of dosage. It is believed that these treatments stimulated and sensitized dopamine D1 receptors, thereby inducing lingual dystonia. Furthermore, the patient demonstrated dyspnea and attacks of apnea caused by the closure of bilateral vocal cords due to laryngeal dyskinesia. After initiation of the neuroleptic, olanzapine, for a short duration, the high dose of levodopa overlapped with neuroleptic sensitivity, suggesting DOPA-induced dystonia and dyskinesia. This interaction can sometimes lead to lethal adverse events, and must be considered very important when treating patients with DLB.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 56 (6), 418-423, 2016
Societas Neurologica Japonica
