Cholinergic balance in dementia with Lewy bodies: reversible worsening of Parkinsonism at rivastigmine dosage modulation

F Clerici; P L Ratti; S Pomati; L Maggiore; A Elia; C Mariani

doi:10.1007/s10072-007-0837-6

Cholinergic balance in dementia with Lewy bodies: reversible worsening of Parkinsonism at rivastigmine dosage modulation

Neurol Sci. 2007 Oct;28(5):282-4. doi: 10.1007/s10072-007-0837-6. Epub 2007 Oct 31.

Authors

F Clerici¹, P L Ratti, S Pomati, L Maggiore, A Elia, C Mariani

Affiliation

¹ Centre for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, Department of Clinical Sciences, Luigi Sacco Hospital, University of Milan, Via G.B. Grassi 74, I-20157, Milan, Italy. francesca.clerici1@unimi.it

PMID: 17972045
DOI: 10.1007/s10072-007-0837-6

Abstract

We describe a patient with probable dementia with Lewy bodies (DLB) whose Parkinsonism worsened after administration of rivastigmine within the therapeutic dose range. Some extrapyramidal signs (EPS) then reversed to pre-treatment level after rivastigmine dose reduction. We draw attention to the need of EPS monitoring during titration of cholinesterase inhibitors in patients with DLB. This is the first report to our knowledge of iatrogenic worsening of Parkinsonism which was successfully managed by dose reduction.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Acetylcholine / metabolism*
Aged
Cholinesterase Inhibitors / administration & dosage*
Cholinesterase Inhibitors / adverse effects
Disease Progression
Humans
Lewy Body Disease / complications
Male
Parkinsonian Disorders / drug therapy*
Parkinsonian Disorders / etiology
Phenylcarbamates / administration & dosage*
Phenylcarbamates / adverse effects
Rivastigmine
Time Factors

Substances

Cholinesterase Inhibitors
Phenylcarbamates
Acetylcholine
Rivastigmine