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Dystonia, tremor, and parkinsonism in a 54 year old man with 2-hydroxyglutaric aciduria

University of Florida Movement Disorders Center, Department of Neurology, McKnight Brain Institute, McKnight Brain Institute, PO Box 100236, Gainesville FL 32610, USA; okun@neurology.ufl.edu

Keywords: glutaric aciduria; parkinsonism; dystonia; extrapyramidal; cerebral palsy

The first 150 words of the full text of this article appear below.

Glutaric aciduria is often considered to be a rapidly progressing dementing illness with only occasional extrapyramidal symptoms, usually described as dystonia.^1–7 We present a case of late onset 2-hydroxygluaric aciduria and slowly progressive dystonia and parkinsonism.

Case report
A 54 year old man was referred to the University of Florida movement disorders center for management of "end stage Parkinson’s disease". He was diagnosed with developmental delay and mild cerebral palsy by his paediatrician, for a failure to meet motor milestones. He had below average grades in school and graduated high school two years behind his age matched peers. At age 26, he noticed a mild intention tremor in his right hand, a mild head tremor, and mild unsteadiness in walking. These were assumed to be potentially parkinsonian features, and later in his 30s he was given the assumed diagnosis of Parkinson’s disease. He was treated with levodopa, dopamine agonists, a monoamine oxidase . . . [Full text of this article]

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