Ipsilateral blepharospasm and contralateral hemidystonia and parkinsonism in a patient with a unilateral rostral brainstem-thalamic lesion: structural and functional abnormalities studied with CT, MRI, and PET scanning.
A patient developed progressive right hemidystonia in childhood. Subsequently, left-sided blepharospasm, slurred and stuttering speech, and right-sided rigidity and bradykinesia, responsive to dopamine agonists, appeared. Investigation with computed tomography and magnetic resonance imaging (MRI) at age 43 years revealed a left-sided calcified rostral brainstem-thalamic lesion of uncertain aetiology. Although no structural lesion was seen in the striatal regions, L-[18F]-fluorodopa uptake was severely diminished in the left striatum but normal on the right. Dopamine receptor binding identified by [11C]-methylspiperone was in the normal range on both sides.
Leenders
K L
KL
MRC Cyclotron Unit, Hammersmith Hospital, London, England.
Frackowiak
R S
RS
Quinn
N
N
Brooks
D
D
Sumner
D
D
Marsden
C D
CD
D000328:Adult; D001764:Blepharospasm / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology*; D003342:Corpus Striatum / Q000378:metabolism; D004421:Dystonia / Q000473:pathology*; D005141:Eyelid Diseases / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010300:Parkinson Disease / Q000473:pathology*; D011954:Receptors, Dopamine / Q000378:metabolism; D017448:Receptors, Dopamine D2; D013788:Thalamus / Q000473:pathology*; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D011954:Receptors, Dopamine; D017448:Receptors, Dopamine D2