Open Access Case report

Successful twin pregnancy in a patient with parkin-associated autosomal recessive juvenile parkinsonism

Takehiro Serikawa1, Takayoshi Shimohata2*, Mami Akashi1, Akio Yokoseki2, Miwa Tsuchiya1, Arika Hasegawa3, Kazufumi Haino1, Ryoko Koike3, Koichi Takakuwa1, Keiko Tanaka34, Kenichi Tanaka1 and Masatoyo Nishizawa2

Author Affiliations

1 Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan

2 Department of Neurology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan

3 Department Neurology, Nishi-Niigata Chuo National Hospital, Niigata 950-2085, Japan

4 Department of Neurology, Kanazawa Medical University, Kanazawa 920-0293, Japan

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BMC Neurology 2011, 11:72  doi:10.1186/1471-2377-11-72

Published: 17 June 2011

Abstract

Background

Pregnancy in patients with Parkinson disease is a rare occurrence. To the best of our knowledge, the effect of pregnancy as well as treatment in genetically confirmed autosomal recessive juvenile parkinsonism (ARJP) has never been reported. Here, we report the first case of pregnancy in a patient with ARJP associated with a parkin gene mutation, ARJP/PARK2.

Case presentation

A 27-year-old woman with ARJP/PARK2 was diagnosed as having a spontaneous dichorionic/diamniotic twin pregnancy. Exacerbation of motor disability was noted between ovulation and menstruation before pregnancy as well as during late pregnancy, suggesting that her parkinsonism might have been influenced by fluctuations in the levels of endogenous sex hormones. During the organogenesis period, she was only treated with levodopa/carbidopa, although she continued to receive inpatient hospital care for assistance in the activities of daily living. After the organogenesis period, she was administered sufficient amounts of antiparkinsonian drugs. She delivered healthy male twins, and psychomotor development of both the babies was normal at the age of 2 years.

Conclusion

Pregnancy may worsen the symptoms of ARJP/PARK2, although appropriate treatments with antiparkinsonian drugs and adequate assistance in the activities of daily living might enable successful pregnancy and birth of healthy children.