A case report: Neuroimaging in an atypical presentation of Parkinson's disease.

INTRODUCTION

Parkinson's disease (PD) is the second leading neurodegenerative disorder in the world. The diagnosis of idiopathic Parkinson's disease (IPD) is mainly through clinical presentation of motor and non-motor symptoms. Motor symptoms include tremor, bradykinesia and rigidity. Atypical parkinsonism may pose a challenge in diagnosing IPD. Functional neuroimaging can assist in diagnosing IPD and in differentiating it from atypical parkinsonism due to other neurodegenerative aetiologies.

PATIENT PRESENTATION: We present a case report of a patient with atypical parkinsonism and mild neurocognitive disorder.

MANAGEMENT AND OUTCOME: Neuroimaging revealed IPD, distinguishing it from other causes of neurocognitive disorders. The patient received multidisciplinary team (MDT) input and appropriate medication, including a fixed combination of carbidopa and levodopa, rivastigmine, venlafaxine and quetiapine with improvement of his symptomatology.

CONCLUSION

Neuroimaging assisted in establishing the diagnosis and guiding treatment.

CONTRIBUTION: Although evidence and studies are needed for definitive use in clinical practice, there is supportive evidence to suggest the diagnostic utility of these modalities in parkinsonian syndromes.