technetium-tc-99m-bicisate and Movement-Disorders

We herein report the case of a 65-year-old woman who presented with the subacute onset of dementia and subsequently developed abnormal behavior and a gait disturbance. Her condition transiently improved; however, within one month, she became drowsy and poorly responsive, with limb chorea and urinary incontinence. Her history of frequently using charcoal led us to diagnose her with carbon monoxide (CO) poisoning. The findings of this case and a literature review suggest that subacute dementia due to CO poisoning recovers late, after a year or more, in patients above sixty years of age, and both hyperbaric oxygen and corticosteroid pulse therapy should be considered in such cases, even after one month.

Topics: Adrenal Cortex Hormones; Aged; Brain; Carbon Monoxide Poisoning; Cysteine; Dementia; Female; Gait; Humans; Hyperbaric Oxygenation; Leukoencephalopathies; Magnetic Resonance Imaging; Movement Disorders; Organotechnetium Compounds; Radiopharmaceuticals; Time Factors; Tomography, Emission-Computed, Single-Photon

To clarify the features of pure akinesia (PA) and progressive supranuclear palsy (PSP) in the early stage of disease.. We investigated 15 PA and 41 PSP patients' clinical and radiologic features including head MRI, ethyl cysteinate dimmer-single photon emission-computed tomography (ECD-SPECT) and iodine-123 meta-iodobenzyl guanidine (123I-MIBG) myocardial scintigraphy. In ECD-SPECT study, cerebral blood flow (CBF) reduction was quantitatively expressed as Z-score, and that in the frontal lobe was evaluated.. Many PSP patients claimed falls as the initial symptom but no PA patients did. Eye movement, as well as optokinetic nystagmus elicitation, was more frequently disturbed in PSP. Dementia, dysarthria and rigidity were also more frequent in PSP than in PA. Midbrain tegmentum atrophy in head MRI was more frequently observed in PSP. CBF in the frontal lobe, especially in the frontal eye field, was significantly lower in PSP than in PA. MIBG myocardial scintigraphy showed no difference between two groups.. PA and PSP show distinct symptoms from the early stage, indicating that they are distinct disorders. The occurrence of falls and eye movement disturbance, as well as CBF reduction at the frontal eye field, is very important for distinguishing these disorders.

Topics: Aged; Atrophy; Cerebrovascular Circulation; Cysteine; Dementia; Diagnosis, Differential; Eye Movements; Female; Frontal Lobe; Humans; Iodine Radioisotopes; Magnetic Resonance Imaging; Male; Movement Disorders; Muscle Rigidity; Nystagmus, Optokinetic; Organotechnetium Compounds; Radiography; Supranuclear Palsy, Progressive; Time Factors; Tomography, Emission-Computed, Single-Photon