[Parkinson's syndrome--second life decade onset]

Incidence of parkinsonism prior age 40 is observed in only 5% of total number of patients, under age of 20 it's very rare.

Male patient, age of 16 was hospitalized at Neurology Clinic regarding depression and anxiety, social withdrawal, studyng difficulties, lack of concentration, hands tremor and impaired balance. Difficulties started slow, three years before hospitalisation with affective symptoms. There was no history of similar disease in patient's family. During neurological examination signs which suggested extrapyramidal lesion were found (tremor, Cogwheel type of rigor, postural difficulties). Diagnosis of juvenile form of parkinsonism was set. Basic laboratory findings including serum caeruloplasmin and cooper level were normal. Neuroradiological investigations were without pathological signs, and visual evoked potentials were patological with left side lateralisation. Psychological tests suggested anxious personality characteristics with high emotional sensitivity, mental control and memory difficulties. Pharmacological approach with direct dopamine agonist (Bromocriptine) was started. On 7.5 mg daily significant reduction of symptoms was observed.

In affective disturbances at younger population differential diagnosis rare form of juvenile parkinsonism should be considered.