Bradykinesia (Pediatric) Etiology
The causes of parkinsonism in children are different from those in adults, and thorough examination usually requires a careful search for metabolic as well as degenerative diseases.
Static (fixed) injury:
Post-infectious (e.g., encephalitis lethargica, Von Economo's disease), stroke
Degenerative:
Juvenile Parkinson's disease (autosomal recessive form is often caused by mutations in one of the Parkin genes); spinocerebellar ataxias (including Machado-Joseph disease - SCA3); Huntington's disease (Westphal variant); pantothenate kinase 2 deficiency (Hallervorden-Spatz disease); Pelizaeus-Merzbacher disease; human immunodeficiency virus (HIV, AIDS); striatal degeneration
Chemical/metabolic:
Dopa-responsive dystonia (due to GTP cyclohydrolase I deficiency, tyrosine hydroxylase deficiency, or other abnormalities of catecholamine metabolism); abnormalities of folate metabolism; Wilson's disease; basal ganglia calcification (Fahr's disease)
Drug-induced:
MPTP poisoning; rotenone; tetrabenazine; reserpine; methyldopa; sedatives; neuroleptics (such as pimozide, haloperidol, risperidone, olanzapine, quetiapine); anti-emetics (such as metoclopramide, prochlorperazine); calcium-channel blockers; isoniazid; serotonin-reuptake inhibitors (e.g., sertraline, fluoxetine); meperidine
Disorders that mimic Parkinsonism:
Catatonia, depression, spasticity, hypothyroidism
