Ascorbate- and Zinc-Responsive Parkinsonism

Objective: To report a case of Parkinsonism rapidly responsive to intravenous replacement of vitamin C and zinc. Case Summary: A 66-year-old man with Parkinsonism, pleural effusion, and bipolar disorder was found to have low serum vitamin C and zinc levels. Intravenous replacement of these micronutrients led to resolution of the movement disorder in less than 24 hours. Discussion: Parkinsonism has been associated with vitamin C deficiency, and recent cases of scurvy complicated by Parkinsonism have responded well to intravenous replacement of vitamin C. In this case, deficiency of zinc may have contributed to the development of a movement disorder. The likely pathophysiology of, and treatment recommendations for, Parkinsonism linked to deficiencies of vitamin C and zinc are reviewed. Conclusions: Whereas vitamin C has a strong link with Parkinsonism, the potential role of zinc has only been suspected. This case report highlights some of the potential links between zinc deficiency and Parkinsonism.