[Lack of specificity of single photon emission computerized tomography in dementia--results of a case of progressive paralysis].
In a 53-year old male suffering from paretic neurosyphilis, SPECT-investigations were performed before and after treatment with high doses of Penicillin G. The patient was admitted for disturbances of speech and concentration, memory disorder and tonic-clonic seizures. Mental examination showed a mild dysphoria and irritability in mood, but no disturbance of orientation, no euphoria or expansive delusions, and no paranoia. Mini-Mental-State examination was within the normal range (28 points); no abnormalities were found on neurologic examination, and CT and MRI investigations showed normal findings. The diagnosis was verified by CSF-examination (pleocytosis, elevated protein, positive Lues reactions). SPECT investigation with Tc 99m HMPAO (20 mCi, single-head rotating camera) revealed a pronounced bilateral parieto-temporal uptake deficiency as observed in patients with dementia of Alzheimer's type. After 18 months the clinical symptoms had remitted, and laboratory findings were improved. On the other hand, the bilateral parieto-temporal uptake deficiency in SPECT remained unchanged. Possible causes of these findings are discussed in relation to neuropathologic findings. It can be concluded that bilateral parieto-temporal uptake deficiency in SPECT is a nonspecific finding and that there is no correlation between clinical improvement and SPECT pattern in paretic neurosyphilis.
Reisecker
F
F
Neurologisch-psychiatrische Abteilung, Barmherzigen Brüder, Graz-Eggenberg.
Költringer
P
P
Lind
P
P
Leblhuber
F
F
Eber
O
O
D003704:Dementia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009494:Neurosyphilis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010291:Paresis / Q000000981:diagnostic imaging*; D010296:Parietal Lobe / Q000000981:diagnostic imaging; D010400:Penicillin G / Q000627:therapeutic use; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon
D010400:Penicillin G
Fehlende Spezifität der Single-photon-Emissionscomputertomographie bei Demenz--Ergebnisse bei einem Fall von progressiver Paralyse.