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[Severe punding in Parkinson's disease].
H El Otmani1, L Raji1, B El Moutaouakil1
1Service de neurologie, CHU Ibn Rochd, Casablanca, Maroc.
L'Encephale
|October 8, 2013
Summary
Punding, a repetitive behavior in Parkinson's disease, can be triggered by dopaminergic drugs. Switching medication, like from pergolide to ropinirole, can significantly improve these symptoms and quality of life.
Area of Science:
- Neurology
- Psychiatry
Background:
- Punding is a distinct stereotypic behavior observed in Parkinson's disease (PD), characterized by repetitive handling of objects or mechanical devices.
- This condition is often underestimated in PD patients and differs from obsessive-compulsive disorder and mania.
- Punding can lead to significant social and familial distress.
Observation:
- A case of severe punding in a 23-year-old woman with Parkinson's disease is presented.
- The patient exhibited unusual repetitive behaviors including sewing, disassembling/reassembling phones, and coloring after a dose increase of pergolide.
- These behaviors were linked to peak-dose dyskinesia, reduced sleep, and diminished quality of life.
Findings:
- Switching pergolide to an equivalent dose of ropinirole resulted in immediate and significant improvement of punding symptoms.
- Punding in Parkinson's disease is thought to be associated with excessive dopaminergic stimulation.
Implications:
- Management of punding often involves adjusting dopaminergic medication dosage or changing the specific drug, particularly dopaminergic agonists.
- This case highlights the importance of recognizing and managing punding to improve patient and family well-being in Parkinson's disease.
- Further research into the epidemiology, pathophysiology, and optimal treatment strategies for punding is warranted.
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