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Parkinsonism vs Drug-Induced – DaTscan — SCE Neurology MCQ

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HardMovement DisordersParkinsonism vs Drug-Induced – DaTscanSCE Neurology

A 40-year-old man with epilepsy on lamotrigine develops asymmetric tremor, micrographia, and reduced arm swing. DaTscan shows reduced left putamen uptake. Is lamotrigine causing his parkinsonism?

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Correct answer: D — No — lamotrigine does not cause parkinsonism; this is likely idiopathic PD

Lamotrigine does not cause drug-induced parkinsonism. The abnormal DaTscan confirms presynaptic dopaminergic neuron loss (idiopathic PD). Drug-induced parkinsonism from dopamine blockers typically has a normal DaTscan. Valproate CAN cause parkinsonism and would be worse. A: Lamotrigine does not cause DIP. C: Not all ASMs cause parkinsonism. D: Valproate can worsen movement disorders. E: Lamotrigine does not block dopamine receptors.

Reference: BNF; NICE NG71