An osteoporotic fracture mimicking cervical dystonia in idiopathic Parkinson's disease.

2.50
Hdl Handle:
http://hdl.handle.net/11287/615676
Title:
An osteoporotic fracture mimicking cervical dystonia in idiopathic Parkinson's disease.
Authors:
Ostrowski, C.; Ronan, L.; Sheridan, R.; Pearce, Vaughan R
Abstract:
We report on a case of a 65-year-old (CD) woman who sustained an atraumatic neck fracture. A combination of Parkinson's disease with motor fluctuations, chronic cervical dystonia and osteoporosis provided the basis for this interesting diagnosis. Mrs CD had progressed to complex phase idiopathic Parkinson's disease within 13 years of diagnosis. During this time she remained independent, only using a wheelchair when her motor fluctuations were bad. In 2011, she developed a sudden onset of neck spasm and occipital neuralgia, initially attributed to severe spasmodic cervical dystonia. Despite a titration regime of analgesics and weaning off of her Parkinson's disease medications, the pain persisted. An X-ray of her cervical spine showed degenerative discopathies from C4 to C7. Mrs CD underwent a trial of Botox injections to no avail and she was admitted acutely under the spinal team after an MRI of her spine showed abnormal oedema of the odontoid peg. Subsequent CT diagnosed a type II fracture of the odontoid peg on the background of severe osteoporotic bone (spinal T score -3.4 on subsequent DEXA scan) and she underwent a successful occipital cervical fusion of C1-C6. What makes this case interesting is the fact that this lady's profound powerful neck movements on a background of osteoporosis led to fracture of her neck. Post-operatively, she admitted to non-adherence to her bisphosphonates, prioritising levodopa in the morning with food rather than taking her alendronate on an empty stomach. She is now pain free and receives annual zolendronate infusions.
Citation:
An osteoporotic fracture mimicking cervical dystonia in idiopathic Parkinson's disease. 2013, 42 (5):658-9 Age Ageing
Publisher:
Oxford Journals
Journal:
Age and ageing
Issue Date:
14-May-2013
URI:
http://hdl.handle.net/11287/615676
DOI:
10.1093/ageing/aft050
PubMed ID:
23672934
Additional Links:
http://ageing.oxfordjournals.org/content/42/5/658.long
Note:
This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.
Type:
Case Report
Language:
en
ISSN:
1468-2834
Appears in Collections:
General Trauma & Orthopaedics; Healthcare for Older People; pre-2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorOstrowski, C.en
dc.contributor.authorRonan, L.en
dc.contributor.authorSheridan, R.en
dc.contributor.authorPearce, Vaughan Ren
dc.date.accessioned2016-07-07T09:35:00Z-
dc.date.available2016-07-07T09:35:00Z-
dc.date.issued2013-05-14-
dc.identifier.citationAn osteoporotic fracture mimicking cervical dystonia in idiopathic Parkinson's disease. 2013, 42 (5):658-9 Age Ageingen
dc.identifier.issn1468-2834-
dc.identifier.pmid23672934-
dc.identifier.doi10.1093/ageing/aft050-
dc.identifier.urihttp://hdl.handle.net/11287/615676-
dc.description.abstractWe report on a case of a 65-year-old (CD) woman who sustained an atraumatic neck fracture. A combination of Parkinson's disease with motor fluctuations, chronic cervical dystonia and osteoporosis provided the basis for this interesting diagnosis. Mrs CD had progressed to complex phase idiopathic Parkinson's disease within 13 years of diagnosis. During this time she remained independent, only using a wheelchair when her motor fluctuations were bad. In 2011, she developed a sudden onset of neck spasm and occipital neuralgia, initially attributed to severe spasmodic cervical dystonia. Despite a titration regime of analgesics and weaning off of her Parkinson's disease medications, the pain persisted. An X-ray of her cervical spine showed degenerative discopathies from C4 to C7. Mrs CD underwent a trial of Botox injections to no avail and she was admitted acutely under the spinal team after an MRI of her spine showed abnormal oedema of the odontoid peg. Subsequent CT diagnosed a type II fracture of the odontoid peg on the background of severe osteoporotic bone (spinal T score -3.4 on subsequent DEXA scan) and she underwent a successful occipital cervical fusion of C1-C6. What makes this case interesting is the fact that this lady's profound powerful neck movements on a background of osteoporosis led to fracture of her neck. Post-operatively, she admitted to non-adherence to her bisphosphonates, prioritising levodopa in the morning with food rather than taking her alendronate on an empty stomach. She is now pain free and receives annual zolendronate infusions.en
dc.language.isoenen
dc.publisherOxford Journalsen
dc.relation.urlhttp://ageing.oxfordjournals.org/content/42/5/658.longen
dc.rightsArchived with thanks to Age and ageingen
dc.subjectWessex Classification Subject Headings::Eldery care.en
dc.subjectWessex Classification Subject Headings::Neurology::Diseases & disorders of the nervous system (e.g. Parkinson's)en
dc.titleAn osteoporotic fracture mimicking cervical dystonia in idiopathic Parkinson's disease.en
dc.typeCase Reporten
dc.identifier.journalAge and ageingen
dc.description.noteThis article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.en
dc.type.versionPublisheden

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