Parkinson disease

Case contributed by Alkies Lapas
Diagnosis probable

Presentation

Patient with tremor

Patient Data

Age: 75 years
Gender: Male
Nuclear medicine

Following the intravenous administration of Ioflupane I-123 (DaTscan), the obtained SPECT images demonstrate asymmetric tracer activity in the corpus striatum.  Specifically, activity in the region of the putamen of the right hemisphere is absent with respect to the contralateral side.  Activity is still visible in the caudate nuclei of both hemispheres resulting in a characteristic comma or crescent shape in the left and a roughly circular or oval focus in the right.  The background uptake is within accepted limits.

Case Discussion

Abnormal I-123 Ioflupane SPECT study demonstrating asymmetric loss of normal radiotracer uptake in the right striatum.

Findings are in keeping with suspected Parkinson disease and help differentiate clinically overlapping conditions including essential tremor and drug-induced parkinsonism, which have preserved dopamine activity.

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