Striatal Dopaminergic Functioning in Patients with Sporadic and Hereditary Spastic Paraplegias with Parkinsonism
This 34-yr-old female visited the hospital because of spastic gait and weakness in the right leg. She had the symptoms for 2 yr, and they slowly became worse. The DTRs were markedly exaggerated with positive Babinski signs. The motor strength of her legs was grade 4. She had right-beating nystagmus on virbration. The patient had the following parkinsonian features: dysarthria, hypomimia, hypophonia, postural tremor, rigidity, and bradykinesia (Unified Parkinson's Disease Rating Scale, 22). She complained of occasional orthostatic dizziness; however, orthostatic blood pressure, urinary function tests were normal. The genetic analysis excluded SPG3, 4, and SCA 2, 3, and 17. After taking anti-parkinsonian medications (levodopa/carbidopa 1200 mg, pramipexole 1.5 mg per day), tremor, bradykinesia, and rigidity were partially improved. During the 5-yr follow-up period, she experienced intermittent dizziness that was not troublesome, and neurological symptoms were slightly aggravated.