FDG- and Dopa-PET in postencephalitic parkinsonism
- PMID: 11145004
- DOI: 10.1007/s007020070018
FDG- and Dopa-PET in postencephalitic parkinsonism
Abstract
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 IPS patients. Our findings indicate that PEP may also be caused by influenza A and furthermore that PET clearly distinguishes PEP from IPS.
Similar articles
-
Postencephalitic parkinsonism: interesting clinico-imaging correlation.J Neurol Sci. 2014 Aug 15;343(1-2):215-7. doi: 10.1016/j.jns.2014.05.062. Epub 2014 Jun 5. J Neurol Sci. 2014. PMID: 24993469
-
Secondary parkinsonism due to focal substantia nigra lesions: a PET study with [18F]FDG and [18F]fluorodopa.Acta Neurol Scand. 1996 Jun;93(6):387-92. doi: 10.1111/j.1600-0404.1996.tb00015.x. Acta Neurol Scand. 1996. PMID: 8836298
-
[Parkinsonian syndrome and post-encephalitic stereotyped involuntary movements responsive to L-dopa].Rev Neurol (Paris). 1996 Apr;152(4):267-71. Rev Neurol (Paris). 1996. PMID: 8763655 French.
-
A historical analysis of the relationship between encephalitis lethargica and postencephalitic parkinsonism: a complex rather than a direct relationship.Mov Disord. 2010 Jul 15;25(9):1116-23. doi: 10.1002/mds.22908. Mov Disord. 2010. PMID: 20629120 Review.
-
[Functional imaging for disorders of basal ganglia].Rinsho Shinkeigaku. 1999 Jan;39(1):30-2. Rinsho Shinkeigaku. 1999. PMID: 10377793 Review. Japanese.
Cited by
-
Considerations on the role of environmental toxins in idiopathic Parkinson's disease pathophysiology.Transl Neurodegener. 2014 May 9;3:10. doi: 10.1186/2047-9158-3-10. eCollection 2014. Transl Neurodegener. 2014. PMID: 24826210 Free PMC article. Review.
-
Parkinson's disease and exposure to infectious agents and pesticides and the occurrence of brain injuries: role of neuroinflammation.Environ Health Perspect. 2003 Jun;111(8):1065-73. doi: 10.1289/ehp.6361. Environ Health Perspect. 2003. PMID: 12826478 Free PMC article. Review.
-
Gene-environment interactions: key to unraveling the mystery of Parkinson's disease.Prog Neurobiol. 2011 Jun;94(1):1-19. doi: 10.1016/j.pneurobio.2011.03.005. Epub 2011 Mar 23. Prog Neurobiol. 2011. PMID: 21439347 Free PMC article. Review.
-
Contemporary Encephalitis Lethargica: phenotype, laboratory findings and treatment outcomes.J Neurol. 2009 Mar;256(3):396-404. doi: 10.1007/s00415-009-0074-4. Epub 2009 Mar 6. J Neurol. 2009. PMID: 19412724
-
Parkinson's disease or Parkinson symptoms following seasonal influenza.Influenza Other Respir Viruses. 2011 Sep;5(5):328-33. doi: 10.1111/j.1750-2659.2011.00232.x. Epub 2011 Mar 21. Influenza Other Respir Viruses. 2011. PMID: 21668692 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous
