A case of early onset Parkinson's disease after major stress

Ke Zou,¹ Wanjun Guo,² Gongshun Tang,³ Bo Zheng,⁴ Zhong Zheng<sup>1

1</sup>Neurobiological Laboratory, ²Mental Health Center, ³Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China; ⁴Huaxi Clinical College, Sichuan University, Chengdu, People's Republic of China

Abstract: A 38-year-old woman experienced sudden onset of rest tremor in the left forearm 1 week after learning that her deeply loved husband was involved in an affair. The patient was in good health and had no neurological disease or prior trauma. The surface electromyography results were consistent with features of the typical rest tremor, and the increased glucose metabolism in the putamen, seen on positron emission tomography scan, was consistent with the early stages of Parkinson's disease (PD). Furthermore, her trembling symptoms were relieved significantly after antiparkinsonian medications. For this patient, stress played an important role in the development of PD. The mechanism may have been the direct effects of numerous neurotransmitters or dopamine depletion after its massive release during severe stress. This case suggests that severe stress can worsen the neurological symptoms and prompted early onset of PD. It is the first case of PD occurring so early in life after exposure to major stress, and arouses our attention to the effects of stress on the nervous system.

Keywords: Parkinson's disease, early onset, stress, positron emission computed tomography, surface electromyography