A lady diagnosed with Parkinson disease at various clinics for last 02 yrs. Severly anxious over her condition, marked tremors all over the body especially coarse irregular tremors left arm. Had little benefit from Sinemet and other medication.
MRI brain normal. Blood profile, metabolic profile, B12, VDRL normal. No evidence of wilson disease. Autoimmune encephalitis profile, ENA profile and csf examination normal. Anti neuronal profile done at our lab showed Anti-Titin ++. Ct scan whole body normal.
IV Methylprednisolone given with anxiolytics and supportive care. After two weeks of therapy marked improvement with disappearance of tremor. After six weeks patient able to perform all her work even without medication.
Possible anti dopamine encephalitis ?