Two brothers developed classical clinical features of parkinsonism during childhood. The course of their disease and response to treatment with levodopa were similar to patients with adult-onset parkinsonism. Their paternal grandfather's brother has drug-induced parkinsonism. Current epidemiological and biochemical evidence leads to the hypothesis that the brothers have impaired ability to synthesize dopamine, possibly because of an inherited deficiency of tyrosine hydroxylase enzyme. Their paternal grandfather's brother has a lesser degree of the enzyme deficiency resulting in clinical parkinsonism only when he was treated with major tranquillizers.
Martin WE, Resch JA, Baker AB. Juvenile Parkinsonism. Arch Neurol. 1971;25(6):494–500. doi:10.1001/archneur.1971.00490060028003
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