The trifecta challenge: Lacunar stroke associated with Parkinson’s disease, and ehlers-danlos syndrome: A challenging case study

Abstract

A 40-year-old man presented with left sided droopy face and hemiparesis, diagnosed with lacunar stroke. The patient had medical history with complex interaction of PD, DVT, stage 4 CKD and EDS. Since treatments aimed at one disease may make the others worse, their divergent symptoms provide a serious therapeutic dilemma. Tremors, cogwheel rigidity and cognitive decline were among the patient's symptoms that clinically pointed to PD. The PD diagnosis was confirmed DaT scan, which were performed due to the patient's younger age, medical history of EDS diagnosed at age 12 with rare positive PLA2G6 gene mutation, and absence of a family history of Parkinson's disease. This case presented a therapeutic challenge and demanded the multispecialty involvement for the patient treatment plan.