Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

15 November 2021: Articles

Video Representation of Dopamine-Responsive Multiple System Atrophy Cerebellar Type

Unusual or unexpected effect of treatment

Jonathan Doan A* , Irfan Sheikh A , Lawrence Elmer A , Mehmood Rashid A

DOI: 10.12659/AJCR.933995

Am J Case Rep 2021; 22:e933995

Video 2. Posttreatment with carbidopa-levodopa neurological examination.Finger-Nose and Past-Pointing Tests: • Patient undergoes repeat assessment of finger-nose and past-pointing tests after treatment with Sinemet 25-100 CR tablet for 3 days. • A continuation of dysmetria with significant overshoot with his dominant right hand is noticeable, but the ataxia component that was seen pretreatment is reduced. • In his nondominant hand (left), the patient continues to have ataxia when he attempts to reach out toward his target, with dysmetria and overshoot that are more pronounced when the patient transitions to the eye closure component of the examination. • Despite limited improvement in this assessment, the patient has marked improvement in the fluidity of his movements. Finger Tap Test: • After treatment with Sinemet, the patient has improved symmetry during the finger tap assessment. • There is also marked improvement in the amplitude of his finger tapping. Rapid Alternating Movement: • No significant improvement in the patient’s dysdiadochokinesia is noted after Sinemet treatment. He continues to have coarse and irregular movements with a remarkable double clap to triple clap with the palmar and dorsal aspect of his hand. • There is improvement in the speed of his inaccuracies, with less stuttering of movement. Heel-Knee Test: • There is no significant improvement in his ataxia after Sinemet treatment. There are still side-to-side oscillations of his heel when he slides his foot up his shin. Gait and Turn en Bloc Assessment: • After Sinemet treatment, significant improvement is seen in the patient’s gait. • A pronounced reduction is seen in his shuffling, with turn en bloc improving from 6 pivot steps to 2 pivot steps with his left foot.

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923