Movement Disorders that Occurred as Late Manifestations of Alzheimer's Disease Controlled by a Low dose of Carbamazepine

Patrick Manckoundia; Jérémie Vovelle; Sylvia Cancemi; Rachid Mahmoudi; Thomas Renoncourt

doi:10.12890/2024_004943

Movement Disorders that Occurred as Late Manifestations of Alzheimer's Disease Controlled by a Low dose of Carbamazepine

Eur J Case Rep Intern Med. 2024 Dec 16;11(12):004943. doi: 10.12890/2024_004943. eCollection 2024.

Authors

Patrick Manckoundia^{1

2}, Jérémie Vovelle¹, Sylvia Cancemi³, Rachid Mahmoudi⁴, Thomas Renoncourt^{1

2}

Affiliations

¹ Department of Geriatrics and Internal Medicine, Champmaillot Hospital, University Hospital, Dijon, France.
² UMR Inserm/U1093 Cognition, Action, Sensorimotor Plasticity, University of Burgundy and Franche Comté, Dijon, France.
³ Department of Medical Care and Rehabilitation in Geriatrics, University Hospital, Dijon, France.
⁴ Department of Internal Medicine and Acute Geriatrics, University Hospital, Reims, France.

Abstract

Introduction: According to the World Health Organization, 44 million people worldwide suffer from Alzheimer's disease. Abnormal movements are atypical symptoms of Alzheimer's disease.

Case description: An 87-year-old woman, followed for Alzheimer's disease, experienced abnormal movements. The episodes lasted 30 minutes, were involuntary, uncontrollable, anarchic, predominantly in the upper limbs, and without loss of consciousness or bladder control. An electroencephalogram ruled out atypical epilepsy. Pharmacovigilance investigation ruled out a drug-related cause. Magnetic resonance imaging revealed abnormalities suggestive of Alzheimer's disease, with no other evidence to explain the abnormal movements. Apart from the presence of Alzheimer's disease biomarkers, cerebrospinal fluid analysis found no abnormality. Dopamine transporter scan rule out an atypical parkinsonian syndrome. Finally, abnormal movements associated with Alzheimer's disease were suspected. Abnormal movements disappeared within 72 hours on low-dose carbamazepine.

Conclusion: This case is educational both because of the clinical presentation and the management of symptoms.

Learning points: The number of people suffering from Alzheimer's disease, the leading cause of major neurocognitive disorders, is expected to reach around 78 million in 2030 and 139 million in 2050.The course of Alzheimer's disease may be punctuated by atypical symptoms, such as abnormal movements.In patients on carbamazepine, we observed a dramatic improvement in abnormal movements associated with Alzheimer's disease.

Keywords: Abnormal movements; Alzheimer’s disease; management.