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DOI: 10.1055/s-0042-1755215
Acute Parkinsonism and basal ganglia lesions after wasp sting
Parkinsonismo agudo e lesões de núcleos da base relacionados a picada de vespaA 52-year-old woman presented with acute malaise, syncope, and confusion after a wasp sting. Examination showed cognitive impairment, bradykinesia, and rigidity. Brain magnetic resonance imaging (MRI) scan disclosed symmetric bilateral basal ganglia hyperintense signal ([Figure 1]). Serum specific wasp-venom immunoglobulin E (IgE) antibodies were strongly positive. The cerebrospinal fluid (CSF) and general blood tests, as well as the electroencephalography (EEG), were normal. She had mild improvement with levodopa, and at 6-months of follow-up MRI she showed remaining basal ganglia lesions.
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Anaphylaxis after insect sting (Hymenoptera) may cause several systemic manifestations such as diarrhea, sneezing, cutaneous rash, and angioedema. Neurological features may include agitation, headache, dizziness, confusion, extrapyramidal signs, and encephalitis.[1] [2] Basal ganglia necrosis-associated Parkinsonism has been previously reported.[3]
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Conflict of Interest
The authors have no conflict of interests to declare.
Author's Contributions
TFAA: study design, patient data collectin and manuscrit wrting; KLSO: patient data collectin and manuscrit writing; MERB, JLP, CMRF, ESM: data interpretation and manuscript critical review.
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References
- 1 Casale TB, Burks AW. Hypmenopter-Sting Hypersensitivity. N Engl J Med 2014; 370 (15) 1432-1439 https://www.nejm.org/doi/10.1056/NEJMcp1302681
- 2 Maramattom BV. Wasp sting-related allergic encephalitis. Pract Neurol 2021; 21 (06) 515-517 DOI: 10.1136/practneurol-2021-003007.
- 3 Leopold NA, Bara-Jimenez W, Hallett M. Parkinsonism after a wasp sting. Mov Disord 1999; 14 (01) 122-127 DOI: 10.1002/1531-8257(199901)14:1<122:AID-MDS1020>3.0.CO;2-S.
Address for correspondence
Publication History
Received: 25 January 2022
Accepted: 15 March 2022
Article published online:
17 October 2022
© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Casale TB, Burks AW. Hypmenopter-Sting Hypersensitivity. N Engl J Med 2014; 370 (15) 1432-1439 https://www.nejm.org/doi/10.1056/NEJMcp1302681
- 2 Maramattom BV. Wasp sting-related allergic encephalitis. Pract Neurol 2021; 21 (06) 515-517 DOI: 10.1136/practneurol-2021-003007.
- 3 Leopold NA, Bara-Jimenez W, Hallett M. Parkinsonism after a wasp sting. Mov Disord 1999; 14 (01) 122-127 DOI: 10.1002/1531-8257(199901)14:1<122:AID-MDS1020>3.0.CO;2-S.
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