technetium-tc-99m-exametazime and Apraxias

The aim of this case report was to present a patient with complete anarthria and orofacial apraxia without other relevant neurological deficit. The clinical features are compatible with anterior operculum syndrome.. A regional brain perfusion scan was done using 99mTc-HMPAO and a SPECT gamma camera. A brain CT scan and an MRI were also performed.. Brain CT and MRI were not diagnostic. On brain SPECT, hypoperfusion of the left inferior area of the frontal lobe was noted.. The patient studied showed an uncommon case of anterior operculum syndrome of focal degenerative origin localized by SPECT. SPECT may be a useful and effective method for diagnosis of this unusual neurological deficit.

Topics: Aged; Apraxias; Brain; Deglutition Disorders; Dysarthria; Humans; Male; Organotechnetium Compounds; Oximes; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Progressive clumsiness developed in the right hand of a 33-year-old man, became bilateral and evolved very slowly for ten years. Another neurological deficit was restricted to a slight impairment of superficial sensations. Magnetic resonance imaging verified an atrophy of bilateral parietal lobes. The cerebral blood flow was markedly decreased in the atrophic area. Pure clumsiness of a very slowly progressive course due to parietal atrophy has never been reported in such a young adult. This clinical picture may suggest another variety of degenerative process.

Topics: Adult; Apraxias; Atrophy; Brain; Cerebrovascular Circulation; Disease Progression; Hand; Humans; Magnetic Resonance Imaging; Male; Motor Cortex; Nerve Degeneration; Organotechnetium Compounds; Oximes; Parietal Lobe; Radionuclide Imaging; Technetium Tc 99m Exametazime

Assessment of cerebral perfusion may elucidate pathogenesis of Landau-Kleffner syndrome (LKS). We obtained 99mTc-HMPAO SPECT studies in five children with LKS and in three children with syndromes of verbal-auditory agnosia. In LKS, perfusion showed temporoparietal asymmetry (9.56% +/- 3.44%) (n = 4) or bilateral parietal abnormality (n = 1). SPECT in non-LKS patients was normal (n = 1), showed (n = 1) totihemispheral hypoperfusion accompanying structural abnormality or (n = 1) a pattern resembling but distinct from LKS. Seizures in LKS patients had never occurred (n = 1), were controlled satisfactorily (n = 2), or poorly (n = 2). Maximum EEG abnormality was left centrotemoral-occipital (n = 1), left frontocentral (n = 1), bitemporal/left central (n = 1), and left central/parasagittal (n = 1). Asymmetric temporoparietal perfusion appears characteristic of LKS, differing from findings in other childhood linguistic disturbances. This abnormality occurs across a spectrum of seizure expression, diverging from the distribution of EEG abnormalities. The SPECT abnormalities parallel PET-defined LKS metabolic abnormalities, and may indicate central pathogenetic features of the disorder.

Topics: Aphasia; Apraxias; Brain; Child; Child, Preschool; Electroencephalography; Epilepsy; Female; Humans; Image Processing, Computer-Assisted; Male; Organotechnetium Compounds; Oximes; Syndrome; Technetium Tc 99m Exametazime; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

Twenty patients satisfying standard clinical criteria for Alzheimer's disease (AD) and six age-matched normal controls were studied using 99mTc hexamethyl-propyleneamine oxime and single photon emission tomography. The AD patients had lower regional cerebral blood flow (rCBF) in the temporal and posterior parietal lobes compared to controls. AD patients with apraxia and aphasia had lower rCBF in the lateral temporal and posterior parietal lobes than AD patients without these features. Within the AD group, correlations were found between neuropsychological tests and rCBF: praxis correlated with posterior parietal activity, memory with left temporal lobe activity and language with activity throughout the left hemisphere.

Topics: Aged; Alzheimer Disease; Aphasia; Apraxias; Brain; Cerebrovascular Circulation; Dominance, Cerebral; Humans; Mental Recall; Neuropsychological Tests; Organometallic Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed