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Steroid-reversible parkinsonism as presentation of polymyalgia rheumatica

Pieranna Fietta1, Paolo Manganelli

  • 1Unità Operativa di Reumatologia e Medicina Interna, Dipartimento Osteo-Articolare, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. farnese15@libero.it

Clinical Rheumatology
|December 24, 2005
PubMed

Insights

Polymyalgia rheumatica (PMR) can present as a parkinsonian syndrome in elderly patients. This neurological symptom resolved quickly with corticosteroid treatment, indicating a link between PMR and neurological manifestations.

Area of Science:

  • Rheumatology
  • Neurology
  • Geriatrics

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory condition common in older adults, causing neck, shoulder, and pelvic stiffness and pain.
  • PMR is linked to giant cell arteritis (GCA) and may involve subclinical vasculitis.
  • Neurological involvement in PMR is rare, with only one reported case of reversible dementia.

Observation:

  • Two elderly patients presented with an akinetic-rigid parkinsonian syndrome.
  • This parkinsonian syndrome was the initial symptom of Polymyalgia rheumatica.
  • The neurological symptoms appeared abruptly.

Findings:

  • The parkinsonian syndrome in both patients resolved completely and rapidly.
  • Corticosteroid treatment was effective in reversing the neurological symptoms.
  • This suggests a direct link between PMR and the parkinsonian presentation.

Implications:

  • Polymyalgia rheumatica may manifest with neurological symptoms like parkinsonism.
  • Early diagnosis and corticosteroid treatment of PMR can reverse such neurological deficits.
  • This expands the known spectrum of PMR's clinical presentation and its response to steroids.

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