Hemiparkinsonism associated with a mesencephalic tumor.
A 66-year-old woman presented with a 3-year history of progressive right-sided hemiparkinsonism manifested by a right-hand resting tremor and right-sided bradykinesia. Magnetic resonance imaging (MRI) of the brain revealed a non-enhanced polycystic mass in the left midbrain. (11)C-methylspiperone ((11)C-NMSP) and (18)F-fluorodopa ((18)F-DOPA) positron emission tomography (PET) revealed a striatal hypometabolism that was restricted to the left side. These findings are consistent with a dysfunction in the left nigrostriatal dopaminergic pathway that is presumably induced by the cystic mass in the left midbrain. This case is significant due to the paucity of reports regarding the occurrence of a relatively pure parkinsonism that is associated with a mesencephalic space-occupying lesion.
Yoshimura
M
M
Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. yoshimur-tky@umin.ac.jp
Yamamoto
T
T
Iso-o
N
N
Imafuku
I
I
Momose
T
T
Shirouzu
I
I
Kwak
S
S
Kanazawa
I
I
D020295:Brain Stem Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002250:Carbon Radioisotopes; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000473:pathology; D004295:Dihydroxyphenylalanine; D015259:Dopamine Agents; D005260:Female; D005462:Fluorine Radioisotopes; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011699:Putamen / Q000000981:diagnostic imaging / Q000473:pathology; D013134:Spiperone / Q000031:analogs & derivatives*; D014055:Tomography, Emission-Computed
D002250:Carbon Radioisotopes; D015259:Dopamine Agents; D005462:Fluorine Radioisotopes; D013134:Spiperone; D004295:Dihydroxyphenylalanine; C039167:3-N-methylspiperone