Segawa Syndrome, a Dramatic Response to Dopamine

Segawa syndrome usually manifests as dystonia, disturbance of gait with fatigue, and may be confused with spasticity. Also known as dopamine-responsive dystonia (DRD), it should be considered in any child who presents with paroxysmal or progressive hypertonia of unknown etiology, which responds dram...

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Main Authors: Omkar Dhungel, Amit Shrestha, Pawan Sharma, Nidesh Sapkota, Raju Paudel
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2024/8154006
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author Omkar Dhungel
Amit Shrestha
Pawan Sharma
Nidesh Sapkota
Raju Paudel
author_facet Omkar Dhungel
Amit Shrestha
Pawan Sharma
Nidesh Sapkota
Raju Paudel
author_sort Omkar Dhungel
collection DOAJ
description Segawa syndrome usually manifests as dystonia, disturbance of gait with fatigue, and may be confused with spasticity. Also known as dopamine-responsive dystonia (DRD), it should be considered in any child who presents with paroxysmal or progressive hypertonia of unknown etiology, which responds dramatically to levodopa. It is a clinical diagnosis, but the level of pterins in cerebrospinal fluid and guanosine triphosphate cyclohydrolase-1 (GTCH 1) gene mutation testing done by molecular genetic testing are confirmatory. Our case is a 45-year female with a family history of similar illness expressed as autosomal recessive inheritance pattern. She had symptoms onset at an early age of 13 years with features of dystonia of predominantly lower limbs, hence the inability to maintain posture and walk. Dramatic improvement with levodopa but sudden deterioration to dystonia due to noncompliance was evident in our patient with troublesome features of concomitant adjustment disorder during presentation.
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spelling doaj-art-4b99c7aab21e49c69325817b603956f92025-08-20T03:34:18ZengWileyCase Reports in Neurological Medicine2090-66762024-01-01202410.1155/2024/8154006Segawa Syndrome, a Dramatic Response to DopamineOmkar Dhungel0Amit Shrestha1Pawan Sharma2Nidesh Sapkota3Raju Paudel4Department of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of NeurologySegawa syndrome usually manifests as dystonia, disturbance of gait with fatigue, and may be confused with spasticity. Also known as dopamine-responsive dystonia (DRD), it should be considered in any child who presents with paroxysmal or progressive hypertonia of unknown etiology, which responds dramatically to levodopa. It is a clinical diagnosis, but the level of pterins in cerebrospinal fluid and guanosine triphosphate cyclohydrolase-1 (GTCH 1) gene mutation testing done by molecular genetic testing are confirmatory. Our case is a 45-year female with a family history of similar illness expressed as autosomal recessive inheritance pattern. She had symptoms onset at an early age of 13 years with features of dystonia of predominantly lower limbs, hence the inability to maintain posture and walk. Dramatic improvement with levodopa but sudden deterioration to dystonia due to noncompliance was evident in our patient with troublesome features of concomitant adjustment disorder during presentation.http://dx.doi.org/10.1155/2024/8154006
spellingShingle Omkar Dhungel
Amit Shrestha
Pawan Sharma
Nidesh Sapkota
Raju Paudel
Segawa Syndrome, a Dramatic Response to Dopamine
Case Reports in Neurological Medicine
title Segawa Syndrome, a Dramatic Response to Dopamine
title_full Segawa Syndrome, a Dramatic Response to Dopamine
title_fullStr Segawa Syndrome, a Dramatic Response to Dopamine
title_full_unstemmed Segawa Syndrome, a Dramatic Response to Dopamine
title_short Segawa Syndrome, a Dramatic Response to Dopamine
title_sort segawa syndrome a dramatic response to dopamine
url http://dx.doi.org/10.1155/2024/8154006
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