Barış İşak1, Pınar Koytak1, Özgür Bilgin2, Hilal Horozoğlu1, Murat Sarıtemur3, Arzu Denizbaşı3, Dilek Günal1

1Marmara University Hospital, Department Of Neurology, Istanbul, Turkey
2Erenkoy Hospital Of Mental And Neurological Disorders, Istanbul, Turkey
3Marmara University Hospital, Department Of Emergency Medicine, Istanbul, Turkey

Keywords: Parkinsonism disease, secondary, drugs, hypocalcemia


In this report, we present a unique case in which the chemotherapeutic agent, i.e., zoledronic acid, deepened the hypocalcemia on the basis of chronic renal failure secondary to multiple myeloma and caused parkinsonism episodes. An 80-year-old female patient, who had been diagnosed as multiple myeloma and had been administered bisphosphonate therapy monthly for six months, was ad¬mitted to our emergency room with two parkinsonism episodes. Low serum calcium levels accompanied parkinsonism symptoms, which subsided with calcium replacement therapy in both episodes. Imaging did not reveal any pathology in the basal ganglia. The fact that the patient was cured both times with calcium replacement suggests that hypocalcemia was the actual cause. This can be interpreted as a unique case, reflecting the reversible functional impairment due to metabolic side effects of a chemotherapeutic agent rather than destructive changes in the basal ganglia.