2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane and Encephalitis

Anti-IgLON5 disease is a rare disorder characterized by a heterogeneous myriad of symptoms that may include sleep disorders, bulbar dysfunction, gait problems, movement disorders, cognitive impairment, oculomotor abnormalities, and nervous system hyperexcitability. Its physiopathology remains unknown, with a combination of both autoimmune and neurodegenerative findings.. We describe clinical, cerebrospinal fluid (CSF), and ioflupane single-photon emission computed tomography (SPECT) findings of a positive case of anti-IgLON5 disease mimicking probable progressive supranuclear palsy (PSP). We performed a literature review of previous publications reporting on anti-IgLON5 disease and ioflupane SPECT.. We report the case of a 66-year-old male who met clinical criteria for probable PSP, in whom ioflupane SPECT showed an alteration of the left presynaptic dopaminergic pathway. However, the presence of atypical neurological symptoms for PSP led to further complementary tests, and IgLON5 antibodies were detected in CSF. According to our literature review, ioflupane SPECT findings have been previously described in only three other patients with anti-IgLON5 disease, with a reduced uptake in the striatum in two of them.. Ioflupane SPECT abnormalities, though scarcely described, are not uncommon in anti-IgLON5 disease. They could be related to nigrostriatal dopaminergic degeneration in the context of the tauopathy component of the disease, but further case descriptions are necessary.

Topics: Aged; Cell Adhesion Molecules, Neuronal; Encephalitis; Humans; Male; Nortropanes; Supranuclear Palsy, Progressive; Tomography, Emission-Computed, Single-Photon

We report a 77-year-old woman suffering from dementia with Lewy bodies (DLB) who presented with Hashimoto encephalopathy. The patient began to mistakenly believe that another person was sleeping in her bed from approximately 70 years of age. She began to show symptoms of parkinsonism after 75 years of age. One night, the patient began to exhibit loitering behavior, and made incomprehensible comments while also exhibiting other abnormal behaviors. Clinical examination revealed rigidity and tremor of the limbs, as well as hallucination, abnormal speech and behavior. We first considered DLB. However, serum anti-thyroglobulin levels turned out to be elevated, indicating Hashimoto encephalopathy as well, and treated the patient with steroid pulse therapy. Her mental symptoms subsequently improved, but rigidity and tremor remained.

Topics: Aged; Autoantibodies; Biomarkers; Encephalitis; Female; Hashimoto Disease; Humans; Immunotherapy; Iodine Radioisotopes; Lewy Body Disease; Methylprednisolone; Nortropanes; Phosphopyruvate Hydratase; Prednisolone; Pulse Therapy, Drug; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

We describe an 84-year-old man with anti-NH2-terminal of α-enolase antibody-positive Hashimoto encephalopathy that clinically mimicked multiple system atrophy who underwent investigation by dopamine transporter SPECT before and after immunotherapy. Before treatment, dopamine transporter SPECT showed reduced striatal I-ioflupane binding, with a mean specific binding ratio of 2.42, even though he had no apparent parkinsonism. After immunotherapy, mean specific binding ratio was improved to 3.22. Dopamine transporter SPECT was useful in this case to detect subclinical striatal dysfunction, and evaluation both before and after immunotherapy helped to distinguish between neurodegenerative disease and neuroimmunological disorder.

Topics: Aged, 80 and over; Diagnosis, Differential; Dopamine Plasma Membrane Transport Proteins; Encephalitis; Hashimoto Disease; Humans; Immunotherapy; Male; Multiple System Atrophy; Nortropanes; Phosphopyruvate Hydratase; Tomography, Emission-Computed, Single-Photon

I-FP-CIT-SPECT is currently used to detect functional impairment of striatal structures. We report herein a case where I-FP-CIT abnormalities are seemingly related to an encephalitis involving substantia nigra. A few months after a documented encephalitis, a 19-year-old woman experienced a Parkinsonism with a right dominance. There was a reduction in the striatal binding of I-FP-CIT, especially on the left side, in accordance with the right dominance of the Parkinsonism.

Topics: Encephalitis; Female; Humans; Parkinsonian Disorders; Substantia Nigra; Tomography, Emission-Computed, Single-Photon; Tropanes; Young Adult