Pediatric autoimmune Parkinsonism and response to deep brain stimulation.

Abstract

INTRODUCTION:

Influenza virus has been associated with cases of Parkinsonism, yet a direct relationship has not been confirmed in the literature. Different mechanisms of post-infectious Parkinsonism have been proposed including inflammatory, oxidative stress, and autoimmune. We report a first to our knowledge case of pediatric autoimmune Parkinsonism with autoantibodies to dopamine D2L receptor (anti-DRD2L antibodies), who underwent deep brain stimulation (DBS) of bilateral globus pallidi (GPi).

CASE REPORT:

A 13-year-old girl presented with Parkinsonism features after a severe case of influenza A. She underwent extensive work-up and was found to have elevated titers for anti-DRD2L antibodies. Patient was initially treated with IVIG and plasmapheresis with mild improvement, but her condition continued to worsen. She was responsive to levodopa; however, she developed severe dyskinesia. Patient underwent DBS implantation resulting in partial improvement in bradykinesia, tremors, and dyskinesia.

CONCLUSION:

This case is meant to raise awareness of a rare potential autoimmune complication after influenza virus and to share the experience and outcome using DBS to palliate some of the symptoms.

• Authors: Yulia Salamatova, Irene Malaty, Suman Ghosh
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 38 Issue 1 Pg. 203-206 (01 2022) ISSN: 1433-0350 [Electronic] Germany
• PMID: 33830323 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Levodopa

Topics

• Adolescent
• Child
• Deep Brain Stimulation (methods)
• Female
• Globus Pallidus (surgery)
• Humans
• Levodopa
• Parkinsonian Disorders (therapy)
• Treatment Outcome
• Tremor