Öz
Antikolinerjik ilaçlar, ekstrapiramidal semptomlar (EPS) da dahil olmak üzere bir dizi durumu tedavi etmek için yaygın olarak kullanılmaktadır. Bununla birlikte, ortaya çıkan kanıtlar antikolinerjik kötüye kullanımı ile Dopa–Duyarlı Distoni (DDD) gibi kalıtsal hareket bozuklukları arasında olası bir bağlantı olduğunu göstermektedir. Distoni ve tremor dahil olmak üzere 30 yıllık istemsiz hareket öyküsü olan 61 yaşında bir kadın olguyu sunuyoruz. Başlangıçta kısmi rahatlama sağlayan biperiden başta olmak üzere çeşitli antikolinerjik ajanlarla tedavi edildi. Ancak semptomları zamanla kötüleşti ve antikolinerjiklere karşı tolerans geliştirdi. Kapsamlı değerlendirmelerden sonra hastaya DDD teşhisi konmuş ve levodopa semptomlarında belirgin bir iyileşme sağlamıştır. Bu makale, özellikle ailesinde hareket bozukluğu öyküsü bulunan hastalarda, antikolinerjik kullanımı ile kalıtsal hareket bozuklukları arasındaki potansiyel ilişkinin önemini vurgulamaktadır. DDD gibi altta yatan durumların erken tanınması ve yönetimi, antikolinerjiklerin gereksiz ve potansiyel olarak zararlı kullanımını önleyerek hasta sonuçlarının iyileşmesine ve bağımlılık ve kötüye kullanım riskinin azalmasını sağlayabilir.
Anahtar Kelimeler
Kaynakça
- Weissbach A, Pauly MG, Herzog R, et al. Relationship of Genotype, Phenotype, and Treatment in Dopa-Responsive Dystonia: MDSGene Review. Mov Disord. 2022;37(2):237-52.
- Tadic V, Kasten M, Brüggemann N, Stiller S, Hagenah J, Klein C. Dopa-responsive dystonia revisited: diagnostic delay, residual signs, and nonmotor signs. Arch Neurol. 2012;69(12):1558-62.
- Cherian A, Paramasivan NK, Divya KP. Dopa-responsive dystonia, DRD-plus and DRD look-alike: a pragmatic review. Acta Neurol Belg. 2021;121(3):613-23.
- López-Laso E, Sánchez-Raya A, Moriana JA, et al. Neuropsychiatric symptoms and intelligence quotient in autosomal dominant Segawa disease. J Neurol. 2011;258(12):2155-62.
- Furukawa Y, Kish SJ. Parkinsonism in GTP cyclohydrolase 1-deficient DOPA-responsive dystonia. Brain. 2015;138(Pt 5):e351.
- Kim R, Jeon B, Lee WW. A Systematic Review of Treatment Outcome in Patients with Dopa-responsive Dystonia (DRD) and DRD-Plus. Mov Disord Clin Pract. 2016;3(5):435-42.
- Alves Júnior AC, Daker MV, Machado AMC, Luna AS, Valladares Neto DC, Valadares ER. Neuropsychiatric and sleep study in autosomal dominant dopa-responsive dystonia. Mol Genet Metab Rep. 2022;31:100870.
- Naja WJ, Halaby A. Anticholinergic Use and Misuse in Psychiatry: A Comprehensive and Critical Review. J Alcohol Drug Depend. 2017;5(2):1000263.
- Trender-Gerhard I, Sweeney MG, Schwingenschuh P, et al. Autosomal-dominant GTPCH1-deficient DRD: clinical characteristics and long-term outcome of 34 patients. J Neurol Neurosurg Psychiatry. 2009;80(8):839-45.
Öz
Anticholinergic drugs are widely employed for the treatment of various conditions, including extrapyramidal symptoms. However, recent research suggests a potential link between the misuse of anticholinergics and inherited movement disorders, such as dopa-responsive dystonia (DRD). This report presents a case study of a 61-year-old woman who had been experiencing involuntary movements, including dystonia and tremors, for 30 years. Initially, she was prescribed anticholinergic agents like biperiden, which provided partial relief. Nevertheless, her symptoms gradually worsened, and she developed a tolerance to anticholinergics. Subsequently, a diagnosis of DRD was confirmed, and her symptoms exhibited significant improvement following treatment with levodopa. This case underscores the importance of healthcare professionals being aware of the potential association between anticholinergic misuse and inherited movement disorders. Early identification and management of underlying conditions like DRD can aid in preventing unnecessary and potentially harmful utilization of anticholinergics, thereby enhancing patient outcomes and reducing the risks of dependence and abuse.
Anahtar Kelimeler
Antichlonicergic syndrome case report dopa-responsive dystonia
Kaynakça
- Weissbach A, Pauly MG, Herzog R, et al. Relationship of Genotype, Phenotype, and Treatment in Dopa-Responsive Dystonia: MDSGene Review. Mov Disord. 2022;37(2):237-52.
- Tadic V, Kasten M, Brüggemann N, Stiller S, Hagenah J, Klein C. Dopa-responsive dystonia revisited: diagnostic delay, residual signs, and nonmotor signs. Arch Neurol. 2012;69(12):1558-62.
- Cherian A, Paramasivan NK, Divya KP. Dopa-responsive dystonia, DRD-plus and DRD look-alike: a pragmatic review. Acta Neurol Belg. 2021;121(3):613-23.
- López-Laso E, Sánchez-Raya A, Moriana JA, et al. Neuropsychiatric symptoms and intelligence quotient in autosomal dominant Segawa disease. J Neurol. 2011;258(12):2155-62.
- Furukawa Y, Kish SJ. Parkinsonism in GTP cyclohydrolase 1-deficient DOPA-responsive dystonia. Brain. 2015;138(Pt 5):e351.
- Kim R, Jeon B, Lee WW. A Systematic Review of Treatment Outcome in Patients with Dopa-responsive Dystonia (DRD) and DRD-Plus. Mov Disord Clin Pract. 2016;3(5):435-42.
- Alves Júnior AC, Daker MV, Machado AMC, Luna AS, Valladares Neto DC, Valadares ER. Neuropsychiatric and sleep study in autosomal dominant dopa-responsive dystonia. Mol Genet Metab Rep. 2022;31:100870.
- Naja WJ, Halaby A. Anticholinergic Use and Misuse in Psychiatry: A Comprehensive and Critical Review. J Alcohol Drug Depend. 2017;5(2):1000263.
- Trender-Gerhard I, Sweeney MG, Schwingenschuh P, et al. Autosomal-dominant GTPCH1-deficient DRD: clinical characteristics and long-term outcome of 34 patients. J Neurol Neurosurg Psychiatry. 2009;80(8):839-45.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | OLGU SUNUMU |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Eylül 2023 |
| Kabul Tarihi | 2 Temmuz 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 28 Sayı: 3 |
This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.