Metoclopramide-induced parkinsonism due to bilateral basal ganglia and brain stem involvement in a patient with laryngeal carcinoma

摘要

Parkinsonism and basal ganglion involvement due to an-tiemetic drugs, such as metoclopramide, is rarely encoun-tered. However, bilateral basal ganglia and brain stem involvement has not yet been reported in patients with drug-induced Parkinsonism. A 52-year-old male patient with laryngeal carcinoma was treated with docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy. Because of severe nausea and vomiting 15 days after the first course of chemotherapy, meto-clopramide was administered. Parkinsonism symptoms were observed on the 6th day of metoclopramide therapy. Cerebral MRI revealed bilateral basal ganglia and brain stem involvement. Metoclopramide therapy was promptly discontinued and oral biperiden was commenced. Par-kinsonism findings almost completely improved on his control examination performed after one month. He was not given metoclopramide during further chemotherapy courses. Cerebral MRI taken after three months revealed that the lesions have completely relieved.This is an extremely rare case of metoclopramide-induced parkinsonism together with brain stem and basal ganglion involvement in a patient with laryngeal carcinoma treated by chemotherapy. The clinical and radiological improve-ment was observed with the cessation of the causative drug and biperiden therapy