A case report of an early onset Parkinson disease and pregnancy

Abstract

Parkinsonism is rare in individuals younger than 40, making its coexistence with pregnancy exceptionally uncommon and clinically challenging. This case report describes the management of a 33-year-old woman with autosomal recessive Parkinson’s disease (two PARK2 gene mutations) who conceived through in vitro fertilization (IVF) due to unexplained subfertility. Her partner tested negative for the mutation. She continued levodopa throughout pregnancy and required a carefully coordinated multidisciplinary approach. She developed pregnancy-induced hypertension, which was controlled with beta-blockers. Her Parkinson’s symptoms worsened toward the end of pregnancy, requiring increased levodopa doses. Due to subfertility, impaired coordination, and mental health concerns, an elective Caesarean section was performed at 38 weeks under spinal anesthesia, resulting in the birth of a healthy baby. She received strong support from neurology, occupational therapy, and physiotherapy teams during pregnancy and the postnatal period. Although postnatal depression had been anticipated, bonding with the baby was good. This case underscores the importance of multidisciplinary, individualized care to achieve favorable maternal and fetal outcomes.