Idiopathic Parkinson’s Disease and Schizophrenia: Dilemma in Diagnosis and Treatment of a Case

Abstract

The relationship between schizophrenia and idiopathic Parkinson’s disease is still not clear and rare when they coexist. Diagnosing coexisting schizophrenia and idiopathic Parkinson’s disease is a chal-lenge, especially in developing countries due to lack of experts and advance imaging facilities. Treatment options are also limited. A 58- year- old male was admitted due to relapse of psychotic symptoms following non-compliance to antipsychotic medications. The patient was previously diag-nosed with schizophrenia and later developed Parkinson’s disease while non-compliant to antipsy-chotic medications. While the patient was at our center, his detailed history was taken and general physical examination was done to distinguish Parkinson’s disease from anti-psychotic induced ex-trapyramidal symptoms. All the routine investigations were within normal limits. This case report highlights the clinical factors that help make a distinction and help use appropriate drugs to manage schizophrenia with comorbid Parkinson’s disease in developing countries, where lack of precise di-agnostic imaging modalities interferes in making a conclusive diagnosis.