Objective: Objective of this report is to discuss the case of Parkinson’s syndrome (PS) in 22 y.o. patient on the background of the pathological process in lamina quadrigemina (tumor? inflammation?) according to MRI, with the presence of obstructive hydrocephalus.

Background: 2 years ago patient was brought unconscious to our clinic from prison, for a long time used cannabinoids. During CT scan occlusive hydrocephalus was revealed. MRI revealed thickening and deformation of lamina quadrigemina with signs of aqueductus cerebri obstruction, pathomorphological changes couldn’t be determined by MRI, laboratory tests were normal.

Methods: In December 2013 – ventriculo-peritoneal shunt operation was performed. In May 2015 signs of shunt’s dysfunction appeared, revision operation was performed.

Results: Postoperatively, in spite of hydrocephalus elimination developed pronounced akinetic – rigid syndrome, which regressed within 3-5 days after amantadine 200 mg/per day appointment. In 2 months akinetic – rigid syndrome considerably increased, against the backdrop of self-amantadine withdrawal, MRI again showed signs of hydrocephalus. Re-executed revision of ventricular end of the valve was performed, and interestingly, akinetic – rigid syndrome kept, and only amantadine 200 mg/per day helped to arrest the syndrome.

Conclusions: This case demonstrates that performing of ventriculo-peritoneal shunt operation and co-administration of amantadine can be effective in the treatment of Parkinson’s syndrome due to pathological process in lamina quadrigemina. The open question is about nature of the process in lamina quadrigemina. From literature we know about immune-mediated mechanisms of PS [1] and additional antiviral effect of amantadine suggests the idea that our patient probably has inflammation in lamina quadrigemina.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-syndrome-as-possible-manifestation-of-lamina-quadrigemina-tumor-or-inflammation/