Session Information
Date: Tuesday, June 6, 2017
Session Title: Therapy in Movement Disorders
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To evaluate possible efficacy and safety of standard antiparkinsonian drugs (levodopa formulations, amantadine) in patients with symptomatic midbrain cavernomas (haemorhage and/or surgery) and secondary movement disorders (SMD).
Background: MEDLINE, PubMED was searched. Limited data, regarding treatment of SMD appearing after haemorhage/surgery of midbrain cavernous angiomas were found.
In our institution for the period of 2011- jul 2016 6 patients with midbrain cavernomas were treated. In 3 patients hemiparesis with or w/o oculomotor nerve palsy was observed. In other 3 additionally SMD were present (two cases of parkinsonism with severe akinesia, in one – Holmes tremor). One case of parkinsonism appeared as a result of haemorhage, other two SMD – after surgery. Combination of standard antiparkinsonian drugs were introduced: levodopa/carbidopa in a slowly tapering (over 5 month) frequent (9XD) low dosage (50 mg) and amantadine sulfate. In Holmes tremor clonazepam after previous unsuccessful treatment with L-dopa was tried.
Methods: modified Rankin Scale (mRS) at onset of treatment, month 6, 9 and 12, Disability Rating Scale (DRS) were measured.
Results: in one patient with damage of substantia nigra (SN) and severe parkinsonism an excellent result was observed after L-dopa treatment with mRS 1, DRS 0 (normal) at 12 month. In other patient with SN and n. ruber damage mild improvement on L-dopa + amantadine was reached with mRS 5, DRS 13 (severe) at 9 month. In patient with Holmes tremor a mild improvement on clonazepam 4.5mg/d was seen, no further dose escalation because of AE(thrombocytopenia), mRS 2, DRS 1 (mild) at 12 month. No AEs were observed on combined L-dopa/amantadine treatment.
Conclusions: L-dopa, amantadine should be tried in a slowly tapering low-dose frequent intake manner in patients with parkinsonism secondary to symptomatic midbrain cavernomas with damage of SN.
To cite this abstract in AMA style:
K. Karpinska, A. Smolanka. Treatment of secondary movement disorders related to midbrain cavernomas [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/treatment-of-secondary-movement-disorders-related-to-midbrain-cavernomas/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/treatment-of-secondary-movement-disorders-related-to-midbrain-cavernomas/