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Reversible Parkinsonism and T1W pallidal hyperintensities in acute liver failure
Author(s) -
Aggarwal Annu,
Vaidya Sachin,
Shah Samir,
Singh Joshita,
Desai Shrinivas,
Bhatt Mohit
Publication year - 2006
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21096
Subject(s) - parkinsonism , hyperintensity , magnetic resonance imaging , medicine , psychology , disease , radiology
We report on a young woman who survived acute liver failure (ALF) without liver transplant. During the ALF, she developed a disabling, levodopa‐unresponsive, symmetrical Parkinsonism. This was characterized by severe bradykinesia, mild rigidity, mutism, and prominent gait impairment. Magnetic resonance imaging (MRI) showed bilateral T1W pallidal hyperintensities. Parkinsonism and MRI changes remitted in parallel with normalization of hepatic function. We implicate excessive pallidal manganese deposition secondary to ALF in the pathogenesis of this neuroradiological syndrome. Though hitherto unreported, we propose that Parkinsonism with T1W pallidal hyperintensities may not be uncommon in ALF. © 2006 Movement Disorder Society