BackgroundParkinsonism following hypoxic ischemic damage of the basal ganglia is an uncommon phenomenon that has been infrequently reported. However, only a few cases have noted improvement of symptoms with dopaminergic therapy. We report the clinical and imaging features of five patients with post-anoxic parkinsonism responsive to dopamine supplementation.ObjectiveTo describe a retrospective case series of five cases of dopamine-responsive post-anoxic parkinsonism.MethodsWe identified all the cases using the Mayo Clinic Data Management System utilizing advanced data explorer search engine for any patients evaluated for post anoxic parkinsonism and its associated acronyms from 2000-2024. Clinical features, neuroimaging, medication trials, and responses were obtained from chart review of identified patients.ResultsFive patients met the inclusion criteria. All patients underwent anoxic events followed by development of parkinsonism. Patients exhibited parkinsonism described as combinations of bradykinesia, rigidity, tremor, and postural instability. All patients underwent evaluation by a neurologist, MRI imaging, and treatment by dopaminergic agents. Of the five patients, four received carbidopa/levodopa whereas one received a dopamine agonist. All patients were clinically followed for a median of approximately 4 years and showed improvement in parkinsonism.ConclusionsParkinsonism following a hypoxic ischemic insult is a rare occurrence but response to dopaminergic therapy in those cases is even more scarcely described. Our cases series provides important implications for treatment options for patients with post anoxic parkinsonism.
Keywords: akinetic-rigid syndrome; dopamine; parkinsonism; post-anoxic.
Signs and symptoms of parkinsonism could develop rarely after damage of the basal ganglia region of the brain from lack of blood flow or oxygen. In those cases, an even smaller group of patients have been reported to respond to dopamine therapy. We describe the clinical details, imaging, and medication regimens of five patients with post-anoxic parkinsonism that improved with dopamine medications. Five patients were identified by searching a patient database for terms that described parkinsonism after anoxic events. Those who responded to dopamine medications were identified and their charts were reviewed for presenting signs and symptoms, medical evaluations, imaging results, and response to various therapeutics including medications that affected the dopamine system. Those cases showed various presentations of parkinsonism after anoxic events that responded well to medications that increase dopamine in the brain which could be helpful for clinicians to treat future patients with similar presentations.