Lesion of the dorsorostral midbrain sparing the nigrostriatal tract mimics axial rigidity seen in progressive supranuclear palsy.
We report on a patient with a residual dorsorostral midbrain lesion after resection of a pineal gland tumor. In addition to severe vertical gaze palsy, this patient exhibited other neurological features closely resembling progressive supranuclear palsy. Normal dopamine transporter single-photon emission computed tomography imaging excluded significant dopamine deficiency. We suggest that dorsorostral midbrain pathology rather than dopamine deficiency due to degeneration of nigrostriatal dopaminergic neurons or basal ganglia nuclei might be responsible for axial rigidity in extension.
Lewerenz
Jan
J
Department of Neurology, University of Hamburg, Hamburg, Germany.
Zurowski
Bartosz
B
Jenicke
Lars
L
Bäumer
Tobias
T
Lees
Andrew J
AJ
Münchau
Alexander
A
D000328:Adult; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D004298:Dopamine / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*; D009493:Neurosurgery / Q000379:methods; D010871:Pinealoma / Q000601:surgery; D011183:Postoperative Complications; D013378:Substantia Nigra / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D004298:Dopamine