Three Cases of Flunarizine-induced Parkinsinism

J Korean Neurol Assoc > Volume 14(4); 1996 > Article

Journal of the Korean Neurological Association 1996;14(4): 995-999.

Flunarizine 유발성 파킨슨증후군 3례

이수주, 이원용

삼성의료원 신경과

Three Cases of Flunarizine-induced Parkinsinism

Soo Joo Lee, M. D., Won Yong Lee, M. D.

Department of Neurology, Samsung Medical Center

Abstract

Background & Significance : Parkinsonism is a rare but well-known side effect of some calcium channel blockers, mainly cinnarizine and flunarizine. Not a few cases of flunarizine-induced parkinsonism have been reported in Europe. Although flunarizine is widely prescribed for vertigo, cerebral blood flow disturbance and migraine prophylaxis, there is no case report of flunarizine-induced parkinsonism in Korea. Case : We experienced 3 patients who had parkinsonism after treatment with flunarizine for between 10 weeks and 14 weeks. Two patients also showed depressive mood during treatment. When flunarizine therapy was discontinued, one patients show complete improvement 4 months after withdrawal. Two patients had so severe parkinsonism that they should take levodopa. All of these patients showed marked improvement in spite of dose-reduction and ceasing of levodopa. All patients met the diagnostic criteria for flunarizine-induced parkinsonism presented by Garcia-Rultz and colleagues in 1992. Detailed clinical features and laboratory findings are described with brief review of related articles. Conclusion : We reported 3 cases of clinically suspected flunarizine-induced parkinsonism. To our knowledge, this is the first case report on flunarizine-induced parkinsonism in Korea. In our cases, as previously reported, aging seems to be a critical risk factor for developing flunarizine-induced parkinsonism. So, we conclude that elderly patients should be treated with flunarizine as seldom as possible and if treated, they should be followed carefully to disclose early signs of parkinsonism.