Slow Periodic Spasms and Rapidly Progressive Parkinsonism Due to Cerebral Amyloid Angiopathy

Abstract

Cerebral amyloid angiopathy (CAA) is characterized by progressive deposition of Aβ protein in the walls of small-to medium-sized leptomeningeal and cortical blood vessels. 1 Clinical manifestations include symptomatic acute lobar intracerebral hemorrhage, chronic progressive cognitive decline and transient focal neurological episodes, with widespread cortical microbleeds in brain MRI. 1 Rarely, it can present as cerebral amyloid angiopathy-related inflammation (CAA-ri) in which there is a perivascular inflammation around amyloid-laden vessels, along with rapid clinical progression and adding cortico-subcortical T2/fluid-attenuated inversion recovery (FLAIR) hyperintensities in brain MRI. Parkinsonism as a presentation of CAA is extremely rare.We report a case of periodic spasms and rapidly progressive parkinsonism caused by probable CAA, ameliorated by corticosteroids.