FDG- and Dopa-PET in postencephalitic parkinsonism

被引:13
作者
Ghaemi, M [1 ]
Rudolf, J [1 ]
Schmülling, S [1 ]
Bamborschke, S [1 ]
Heiss, WD [1 ]
机构
[1] Univ Cologne, Neurol Klin, D-50924 Cologne, Germany
关键词
viral encephalitis; encephalitis lethargica; postencephalitic parkinsonism; influenza A; positron emission tomography;
D O I
10.1007/s007020070018
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We report a case of a 74-year old woman who following an acute virus encephalitis developed an akinetic-rigid Parkinson syndrome with tremor, hypokinesia, hypomimia, rigidity and cogwheel phenomenon in all four extremities, brady-dysdiadochokinesia as well as myoclonic jerks of the arms. Many of the clinical features of this postencephalitic parkinsonism (PEP) suggested the diagnosis of sporadic encephalitis lethargica, first described by von Economo 1917. Cerebral spinal fluid showed signs of a viral. encephalitis, and a positive influenza A IgA-antibody titer (1:>160) in the viral serologic screen was found. Positron emission tomography (PET) showed an altered pattern of glucose- and dopa-metabolism clearly different from findings in idiopathic Parkinson syndrome (IPS). The acute lack of inhibitory input from the substantia nigra pars compacta to the striatum could explain the different metabolic patterns in our case in comparison to IFS patients. Our findings indicate that PEP may also be caused by influenza A and furthermore that PET clearly distinguishes PEP from IPS.
引用
收藏
页码:1289 / 1295
页数:7
相关论文
共 18 条
[1]   COMPLEMENTARY POSITRON EMISSION TOMOGRAPHIC STUDIES OF THE STRIATAL DOPAMINERGIC SYSTEM IN PARKINSONS-DISEASE [J].
ANTONINI, A ;
VONTOBEL, P ;
PSYLLA, M ;
GUNTHER, I ;
MAGUIRE, PR ;
MISSIMER, J ;
LEENDERS, KL .
ARCHIVES OF NEUROLOGY, 1995, 52 (12) :1183-1190
[2]   Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson's disease [J].
Antonini, A ;
Leenders, KL ;
Vontobel, P ;
Maguire, RP ;
Missimer, J ;
Psylla, M ;
Günther, I .
BRAIN, 1997, 120 :2187-2195
[3]  
BERNHEIMER H, 1973, J NEUROL SCI, V20, P415, DOI 10.1016/0022-510X(73)90175-5
[4]   PET study and neuropsychological assessment of a long-lasting post-encephalitic parkinsonism [J].
Caparros-Lefebvre, D ;
Cabaret, M ;
Godefroy, O ;
Steinling, M ;
Rémy, P ;
Samson, Y ;
Petit, H .
JOURNAL OF NEURAL TRANSMISSION, 1998, 105 (4-5) :489-495
[5]   Postencephalitic parkinsonism - a review [J].
Casals, J ;
Elizan, TS ;
Yahr, MD .
JOURNAL OF NEURAL TRANSMISSION, 1998, 105 (6-7) :645-676
[6]  
CONRAD B, 1996, BEWEGUNGSSTORUNGEN N, P11
[7]   REVERSIBLE STRIATAL HYPERMETABOLISM IN A CASE OF SYDENHAM CHOREA [J].
GOLDMAN, S ;
AMROM, D ;
SZLIWOWSKI, HB ;
DETEMMERMAN, D ;
GOLDMAN, S ;
BIDAUT, LM ;
STANUS, E ;
LUXEN, A .
MOVEMENT DISORDERS, 1993, 8 (03) :355-358
[8]   REGIONAL KINETIC CONSTANTS AND CEREBRAL METABOLIC-RATE FOR GLUCOSE IN NORMAL HUMAN VOLUNTEERS DETERMINED BY DYNAMIC POSITRON EMISSION TOMOGRAPHY OF [F-18]-2-FLUORO-2-DEOXY-D-GLUCOSE [J].
HEISS, WD ;
PAWLIK, G ;
HERHOLZ, K ;
WAGNER, R ;
GOLDNER, H ;
WIENHARD, K .
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 1984, 4 (02) :212-223
[9]   DISCORDANT TWINS WITH PARKINSONS-DISEASE - POSITRON EMISSION TOMOGRAPHY AND EARLY SIGNS OF IMPAIRED COGNITIVE CIRCUITS [J].
HOLTHOFF, VA ;
VIEREGGE, P ;
KESSLER, J ;
PIETRZYK, U ;
HERHOLZ, K ;
BONNER, J ;
WAGNER, R ;
WIENHARD, K ;
PAWLIK, G ;
HEISS, WD .
ANNALS OF NEUROLOGY, 1994, 36 (02) :176-182
[10]   Functional effects of striatal dysfunction in Parkinson disease [J].
HolthoffDetto, VA ;
Kessler, J ;
Herholz, K ;
Bonner, H ;
Pietrzyk, U ;
Wurker, M ;
Ghaemi, M ;
Wienhard, K ;
Wagner, R ;
Heiss, WD .
ARCHIVES OF NEUROLOGY, 1997, 54 (02) :145-150