Parkinson hastalığında impuls kontrol bozukluğu: Olgu sunumu

Parkinson hastalığının ileri evrelerinde, motor komplikasyonlara ek olarak, davranış bozuklukları şeklinde ortaya çıkabilen non-motor komplikasyonlar da görülebilmektedir. Bu yazıda, üç yıl önce Parkinson hastalığı tanısı konmuş, levodopa tedavisine dopamin agonisti eklendikten sonra aşırı yemek yeme ve cinsel istekte artış yakınmaları başlamış olan 73 yaşında erkek hasta sunuldu. Hastaya muayene ve değerlendirilmesi sonucunda, dopamin replasman tedavisine bağlı gelişen hiperseksüalite ve kompulsif yemek yeme ile ortaya çıkan impuls kontrol bozukluğu tanısı kondu. Dopamin agonisti tedavisi kesildikten sonra bu sorunların kaybolduğu görüldü.

Anahtar Kelimeler:

Parkinson hastalığı, Dopamin agonistleri, Dürtü kontrol bozuklukları, Cinsel davranış, Yaşlı, Yeme bozuklukları, Erkek

Impulse control disorder in Parkinson's disease: A case report

In the advanced stages of Parkinson's disease, non-motor complications presenting as behavioral disorders can accompany motor complications. In this report, we presented a 73-year-old male patient who had Parkinson's disease of three-year duration and developed excessive eating and sexual desire after the addition of a dopamine agonist to levodopa treatment. Impulse control disorders manifesting as compulsive eating and hypersexuality were attributed to dopamine replacement therapy. After the cessation of the dopamine agonist these behavioral disorders disappeared.

Keywords:

Parkinson Disease, Dopamine Agonists, Impulse Control Disorders, Sexual Behavior, Aged, Eating Disorders, Male,

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1) Galvez-Jimenez N, editor. Scientific basis for the treatment of Parkinson's disease. London: Taylor&Francis Group; 2005. Çeviri editörü: Dursun AN. Parkinson hastalığının patolojisi-son gelişmeler. In: Parkinson hastalığının tedavisi için bilimsel temeller. İstanbul: AND Danışmanlık, Eğitim, Yayıncılık ve Organizasyon; 2005. s. 53-86.
2) Schrag A. Psychiatric aspects of Parkinson's disease-an update. J Neurol 2004;251:795-804.
3) Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, et al. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol 2006;63:969-73.
4) Giovannoni G, O'Sullivan JD, Turner K, Manson AJ, Lees AJ. Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry 2000;68:423-8.
5) Evans AH, Lees AJ. Dopamine dysregulation syndrome in Parkinson's disease. Curr Opin Neurol 2004;17:393-8.
6) Kurlan R. Disabling repetitive behaviors in Parkinson's disease. Mov Disord 2004;19:433-7.
7) Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text revision. Washington: American Psychiatric Association; 2000.
8) Voon V, Hassan K, Zurowski M, de Souza M, Thomsen T, Fox S, et al. Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology 2006;67:1254-7.
9) Aarsland D, Alves G, Larsen JP. Disorders of motivation, sexual conduct, and sleep in Parkinson's disease. Adv Neurol 2005;96:56-64.
10) Imamura A, Uitti RJ, Wszolek ZK. Dopamine agonist therapy for Parkinson disease and pathological gambling. Parkinsonism Relat Disord 2006;12:506-8.
11) Voon V, Hassan K, Zurowski M, Duff-Canning S, de Souza M, Fox S, et al. Prospective prevalence of pathologic gambling and medication association in Parkinson disease. Neurology 2006;66:1750-2.
12) Tyne HL, Medley G, Ghadiali E, Steiger MJ. Gambling in Parkinson's disease. Movement Disorders 2004; 19(suppl 9):195.
13) Driver-Dunckley E, Samanta J, Stacy M. Pathological gambling associated with dopamine agonist therapy in Parkinson's disease. Neurology 2003;61:422-3.
14) Dodd ML, Klos KJ, Bower JH, Geda YE, Josephs KA, Ahlskog JE. Pathological gambling caused by drugs used to treat Parkinson disease. Arch Neurol 2005; 62:1377-81.
15) Evans AH, Katzenschlager R, Paviour D, O'Sullivan JD, Appel S, Lawrence AD, et al. Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome. Mov Disord 2004;19:397-405.
16) Galpern WR, Stacy M. Management of impulse control disorders in Parkinson's disease. Curr Treat Options Neurol 2007;9:189-97.