Eye of the tiger sign (globus pallidus)

Last revised by Rohit Sharma on 16 May 2024

The eye of the tiger sign refers to symmetric bilateral abnormal low signal on T2-weighted MRI (due to abnormal accumulation of iron) in the globus pallidus with central high signal (due to gliosis and spongiosis).

The eye of the tiger sign is most classically associated with pantothenate kinase-associated neurodegeneration (PKAN) 1-3, although it is not pathognomonic, particularly in adults 5.

There are no formalized criteria for the sign 6 and other conditions, such as Wilson disease 7, atypical parkinsonism 8, and organophosphate poisoning 9 may demonstrate a similar appearance. It may also be a normal finding on 3 T MRI 6. Therefore, caution should be used when interpreting this sign.

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