Cerebrospinal Fluid Monoamine Metabolite Analysis in Pediatric Movement Disorders

J Child Neurol. 2015 Nov;30(13):1800-5. doi: 10.1177/0883073815581608. Epub 2015 Apr 23.

Abstract

Abnormal concentrations of dopamine and serotonin metabolites in the cerebrospinal fluid is the diagnostic hallmark of a group of treatable conditions known as the monoamine neurotransmitter disorders. We assessed cerebrospinal fluid dopamine and serotonin metabolite concentrations in a series of 69 patients affected by movement disorders of unknown etiology. Abnormal results were disclosed in 13/69 subjects (19%). Both primary and secondary monoamine neurotransmitter disorders were observed. The clinical presentation of both forms was hypokinetic-rigid syndrome or dystonia. L-Dopa treatment resulted in significant improvement of the clinical picture in the majority of primary neurotransmitter disorders. Eight patients presented a secondary neurotransmitter disorder. One suffered from a GM2 gangliosidosis and one from infantile bilateral striatal necrosis. Etiologic diagnoses were not established in the others. L-Dopa was started in four patients, leading to a significant improvement of hypokinesia in the patient suffering from GM2 gangliosidosis and a slight improvement in 3 unclassified patients.

Keywords: dystonia; hypokinetic-rigid syndrome; movement disorders; neurotransmitter disorders.

MeSH terms

  • Adolescent
  • Anti-Dyskinesia Agents / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Levodopa / therapeutic use
  • Male
  • Movement Disorders / cerebrospinal fluid*
  • Movement Disorders / drug therapy
  • Neurotransmitter Agents / cerebrospinal fluid*
  • Young Adult

Substances

  • Anti-Dyskinesia Agents
  • Neurotransmitter Agents
  • Levodopa