A 75-year-old woman presented to the gastroenterology department referred by her primary care physician for dyspeptic symptoms of dysmotility of a few months duration.
She had no warning symptoms and had not improved with medication prescribed by her doctor with proton pump inhibitors.
On physical examination, the patient complained of mild discomfort associated with the placement of epigastrium and right hypochondrium without the presence of masses or organomegaly.
An analytical study and abdominal ultrasound were requested, which were normal.
Possibly gasoscopy was performed with findings of uncomplicated hiatus hernia and chronic antral gastritis confirmed by biopsy.
The presence of Helicobacter pylori was ruled out by urease test and biopsy.
With these findings it was decided to start treatment with clebopride at a dose of 0.5 mg three times a day before meals.
One month after starting treatment, the patient came to her primary care physician complaining of abnormal ambulation and decay, which was initially interpreted as depressive symptoms, so treatment with citalopram was initiated.
The patient experiences progressive worsening, with significant difficulty in walking, stiffness, postural instability and tremor, so she is referred to internal medicine consultation where after performing neurological examinations to rule out secondary organic causes she is diagnosed with Parkinsonism.
Treatment with clebopride is suspended and progressively the patient recovers her basal situation persisting at present three months after the diagnosis mild tremor and gait disturbance.
