A case of levodopa-responsive camptocormia associated with advanced Parkinson's disease

Ho, Bryan; Prakash, Rajan; Morgan, John C.; Sethi, Kapil D.

doi:10.1038/ncpneuro0584

Cited by 35 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a patient with MSA with predominant parkinsonism, camptocormia and Parkinson’s disease markedly improved under L -DOPA [74]. In a patient with Parkinson’s disease, adjustment of dopaminergic therapy by carbidopa-levodopa and entacarpone resulted not only in improvement of Parkinson’s disease but also of camptocormia [76]. …”

Section: Treatmentmentioning

confidence: 99%

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Finsterer

Strobl

2010

Eur Neurol

View full text Add to dashboard Cite

Camptocormia (bent spine syndrome, cyphose hystérique) is an abnormality characterized by severe forward flexion of the thoracolumbar spine which typically increases during walking or standing and completely disappears in supine position. Camptocormia can be due to central nervous system diseases, such as Parkinson’s disease, dystonia, multisystem atrophy, or Alzheimer’s disease, due to peripheral nervous system diseases, such as primary myopathy, secondary myopathy, motor neuron disease, myasthenia, or chronic inflammatory demyelinating polyneuropathy, due to side effects of drug treatment, due to disc herniation, arthritis or spinal trauma, or due to paraneoplasia. Only rarely may camptocormia be attributable to psychiatric disease. The diagnosis is based on clinical findings, imaging of the cerebrum or spine, needle electromyography, or muscle biopsy. Treatment options are limited and frequently futile and rely on conservative measures, such as psychotherapy, physiotherapy, use of orthoses, drugs, injection of botulinum toxin, withdrawal of causative drugs, electroconvulsive therapy, or invasive measures, such as surgical correction or deep brain stimulation. The outcome is generally fair. Some patients profit from therapy whereas others do not respond to treatment and become progressively immobile.

show abstract

Section: Treatmentmentioning

confidence: 99%

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Finsterer

Strobl

2010

Eur Neurol

View full text Add to dashboard Cite

show abstract

“…Mechanisms underlying the development of the postural abnormalities in PD are not well understood, but a number of possible mechanisms, such as dystonia, rigidity, drugs, myopathy, skeletal and soft tissue changes, and proprioceptive disintegration have been proposed [1]. There is insufficient evidence to support the effectiveness of the adjustment of antiparkinson medications [2,3], deep brain stimulation [4][5][6], botulinum toxin or Lidocaine injections [7,8], and orthosis and physiotherapy [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

In-Home Posture Evaluation and Visual Feedback Training to Improve Posture with a Kinect-Based System in Parkinson’s Disease

Okada¹

2014

J Nov Physiother

View full text Add to dashboard Cite

“…Many possible causes of camptocormia have been reported, including muscle rigidity and dystonia in the abdomen, proprioceptive deficits, adverse effects of dopamine agonists, soft tissue imbalance, and fatty degeneration and myopathy in the back muscles, but details remain unclear [7]. Although there is no effective curative therapy, several symptomatic therapies are reported to be effective, including dosage of oral carbidopa/levodopa or dopamine agonists, botulinum toxin injections, and DBS [3,[8][9][10][11]. Meanwhile, pain in the low back and legs is common in Parkinson's disease, with a prevalence of approximately 40-85% [3].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of spinal cord stimulation for painful camptocormia with Pisa syndrome in Parkinson’s disease: a case report

et al. 2017

View full text Add to dashboard Cite

Background: Spinal cord stimulation (SCS) has recently been reported to be effective for truncal postural abnormalities such as camptocormia and Pisa syndrome in Parkinson's disease. In this case report, we describe a case of a woman with Parkinson's disease in whom SCS was effective for painful camptocormia with Pisa syndrome. Case presentation: A 65-year-old woman was admitted to our hospital because of painful camptocormia. She had noticed resting tremor in the left upper limb and aprosody at 48 years of age. She was diagnosed as having Parkinson's disease (Hoehn & Yahr stage 1) at 53 years of age. Cabergoline was started during that same year, with subsequent addition of selegiline hydrochloride; the symptoms of parkinsonism disappeared. Wearing-off occurred when she was 57 years old, 3 years after starting carbidopa/levodopa, and truncal postural abnormalities-painful camptocormia with Pisa syndrome to the right-appeared at 58 years of age. These symptoms worsened despite adjustment of her oral medications, and deep brain stimulation (DBS) was performed when she was 60 years old. The truncal postural abnormalities improved after DBS, and she could travel abroad at 61 years of age. However, from 62 years of age, painful camptocormia with Pisa syndrome to the right reappeared. The pain was unsuccessfully treated with oral analgesics, radiofrequency coagulation of the dorsal and medial branches of the lumbar spinal nerve, and lumbar epidural block. Finally, SCS was performed for the pain relief. The pain disappeared immediately after SCS and her posture then gradually improved. Unified Parkinson's Disease Rating Scale score improved from 48 to 34 points and Timed Up and Go Test improved from 15 s to 7 s after SCS. Conclusions: This case suggests that SCS may be effective for improving painful truncal postural abnormalities and motor complications of Parkinson's disease. Pain relief or a direct effect on the central nervous system by SCS was considered to explain the alleviation of these symptoms.

show abstract

A case of levodopa-responsive camptocormia associated with advanced Parkinson's disease

Abstract: Adjustment of dopaminergic therapy (carbidopa-levodopa and entacapone) to minimize motor fluctuations and camptocormia.

Cited by 35 publications

References 16 publications

Presentation, Etiology, Diagnosis, and Management of Camptocormia

Presentation, Etiology, Diagnosis, and Management of Camptocormia

In-Home Posture Evaluation and Visual Feedback Training to Improve Posture with a Kinect-Based System in Parkinson’s Disease

Effectiveness of spinal cord stimulation for painful camptocormia with Pisa syndrome in Parkinson’s disease: a case report

Contact Info

Product

Resources

About