Dopa-responsive dystonia in a ten-year-old girl
Venkatesh Soma1, Hussain Sadiq Mohammed1, Ebrahim Riyas1
1Department of Pediatrics, AVMC and H, Kirumampakkam, Puducherry, India.
Insights
Dopa-responsive dystonia (DRD) is a challenging diagnosis in children presenting with gait issues. Prompt diagnosis and treatment with levodopa/carbidopa can lead to dramatic symptom improvement.
Area of Science:
- Neurology
- Genetics
- Pediatrics
Background:
- Recent onset dystonia and gait abnormalities in children can present diagnostic challenges.
- Dopa-responsive dystonia (DRD) is an inherited neurological disorder characterized by dystonia with diurnal variation.
Observation:
- A 10-year-old girl with normal development presented with a 6-month history of progressive gait abnormality and dystonia.
- Her symptoms exhibited diurnal variation, worsening as the day progressed.
Findings:
- A therapeutic trial with levodopa/carbidopa resulted in a dramatic improvement in symptoms.
- This response confirmed the diagnosis of dopa-responsive dystonia (DRD).
Implications:
- DRD diagnosis is supported by a positive response to levodopa/carbidopa, especially with diurnal symptom variation.
- While typically autosomal dominant, autosomal-recessive inheritance patterns for DRD are also recognized.
- Early diagnosis and treatment are crucial for managing DRD in pediatric patients.
Abstract:
Children with recent onset dystonia and gait abnormalities may pose a diagnostic challenge. A ten-year-old, developmentally normal girl, presented with a six-month history of gait abnormality and dystonia. Her complaint worsened as the day progressed. In view of typical diurnal variation of dystonia, a therapeutic challenge with levodopa/carbidopa was given and there was a dramatic response. Hence, a diagnosis of dopa-responsive dystonia (DRD) was made. DRD is an inherited disorder characterized by dystonia with diurnal variation and favorable response to levodopa/carbidopa. The inheritance is usually autosomal dominant, however, in some cases, autosomal-recessive inheritance is also seen.
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