Postanoxic Akinesia with Bilateral Pallidal Lesions: A PET Study
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- Kobayashi Shunsuke
- Department of Neurology, School of Medicine, Fukushima Medical University, Japan Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, Japan
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- Momose Toshimitsu
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Japan
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- Sakurai Masaki
- Department of Physiology, Teikyo University School of Medicine, Japan Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, Japan
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- Kanazawa Ichiro
- Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, Japan
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Abstract
A 70-year-old woman developed marked akinesia after an anoxic event related to bronchiectasia. Magnetic resonance imaging studies revealed lesions in the bilateral globus pallidus and, to a lesser extent, in the putamen. Positron emission tomography studies with 18F-6-fluoro-L-dopa and 11C-N-methylspiperone showed a decreased pre- and post-synaptic uptake in the striatum. Consistent with previous reports, the present case demonstrated the basal ganglia, particularly the globus pallidus, to be selectively susceptible to anoxic insults. Furthermore, a PET study indicated a disrupted presynaptic integrity of the dopaminergic terminals and decreased dopamine D2 receptor binding, which together appear to underlie the pathophysiology of post-anoxic akinesia, at least in the present case.<br>
Journal
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- Internal Medicine
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Internal Medicine 51 (17), 2449-2451, 2012
The Japanese Society of Internal Medicine