Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia
Objectives: We report the case of a 16-year-old patient with progressive generalized choreo-dystonia that appeared two months after a suicide attempt by hanging associated with a cardiorespiratory arrest. An initial magnetic resonance imaging (MRI) brain scan was judged normal by radiologists. Disco...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2016-10, Vol.43 (11), p.2098-2099 |
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| creator | David, Pierre-Maxime Icard, Nicolas Gauvrit, Jean-Yves Vérin, Marc Le Jeune, Florence |
| description | Objectives: We report the case of a 16-year-old patient with progressive generalized choreo-dystonia that appeared two months after a suicide attempt by hanging associated with a cardiorespiratory arrest. An initial magnetic resonance imaging (MRI) brain scan was judged normal by radiologists. Discordance between clinical presentation and morphological imaging led to the hypothesis of a psychogenic dystonia but striatal lesions were suspected by neurologists.Methods: A second MRI high field was performed and the patient also underwent 123I-fluopane single photon emission computed tomography (SPECT). MRI and SPECT fusion images were analysed.Results: The second MRI failed to reveal any lesions involving the basal ganglia. 123I-fluopane-SPECT, however, highlighted bilateral posterior putaminal presynaptic dopaminergic denervation. Post hoc analysis of MRI and SPECT fusion images confirmed bilateral posterior putamen lesions, with low signal intensity on DWI, confirming the diagnosis of postanoxic generalized dystonia.Conclusions: We report this case to highlight the utility of multimodal imaging in diagnosis of bilateral lesions in difficult neurologic disorders where there is discordance between the clinical presentation and morphological brain imaging. |
| doi_str_mv | 10.1007/s00259-016-3413-6 |
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An initial magnetic resonance imaging (MRI) brain scan was judged normal by radiologists. Discordance between clinical presentation and morphological imaging led to the hypothesis of a psychogenic dystonia but striatal lesions were suspected by neurologists.Methods: A second MRI high field was performed and the patient also underwent 123I-fluopane single photon emission computed tomography (SPECT). MRI and SPECT fusion images were analysed.Results: The second MRI failed to reveal any lesions involving the basal ganglia. 123I-fluopane-SPECT, however, highlighted bilateral posterior putaminal presynaptic dopaminergic denervation. Post hoc analysis of MRI and SPECT fusion images confirmed bilateral posterior putamen lesions, with low signal intensity on DWI, confirming the diagnosis of postanoxic generalized dystonia.Conclusions: We report this case to highlight the utility of multimodal imaging in diagnosis of bilateral lesions in difficult neurologic disorders where there is discordance between the clinical presentation and morphological brain imaging.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-016-3413-6</identifier><identifier>PMID: 27178272</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Basal ganglia ; Basal Ganglia - diagnostic imaging ; Basal Ganglia Diseases - diagnostic imaging ; Bioengineering ; Cardiology ; Case reports ; Diagnosis, Differential ; Dystonia ; Dystonic Disorders - diagnostic imaging ; Dystonic Disorders - etiology ; Ganglia ; Human health and pathology ; Humans ; Hypoxia, Brain - complications ; Hypoxia, Brain - diagnostic imaging ; Image of the Month ; Imaging ; Lesions ; Life Sciences ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Multimodal Imaging - methods ; Nuclear Medicine ; Oncology ; Orthopedics ; Psychiatrics and mental health ; Radiology ; Tomography, Emission-Computed, Single-Photon - methods</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2016-10, Vol.43 (11), p.2098-2099</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Journal of Nuclear Medicine and Molecular Imaging is a copyright of Springer, (2016). All Rights Reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-aebeffe4ba7d541dc346eb2ff50878cebea54e27fe88a5be6b6b2b18075e51bf3</citedby><cites>FETCH-LOGICAL-c449t-aebeffe4ba7d541dc346eb2ff50878cebea54e27fe88a5be6b6b2b18075e51bf3</cites><orcidid>0000-0002-8057-6004</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-016-3413-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-016-3413-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27178272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-rennes.hal.science/hal-01371659$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>David, Pierre-Maxime</creatorcontrib><creatorcontrib>Icard, Nicolas</creatorcontrib><creatorcontrib>Gauvrit, Jean-Yves</creatorcontrib><creatorcontrib>Vérin, Marc</creatorcontrib><creatorcontrib>Le Jeune, Florence</creatorcontrib><title>Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Objectives: We report the case of a 16-year-old patient with progressive generalized choreo-dystonia that appeared two months after a suicide attempt by hanging associated with a cardiorespiratory arrest. An initial magnetic resonance imaging (MRI) brain scan was judged normal by radiologists. Discordance between clinical presentation and morphological imaging led to the hypothesis of a psychogenic dystonia but striatal lesions were suspected by neurologists.Methods: A second MRI high field was performed and the patient also underwent 123I-fluopane single photon emission computed tomography (SPECT). MRI and SPECT fusion images were analysed.Results: The second MRI failed to reveal any lesions involving the basal ganglia. 123I-fluopane-SPECT, however, highlighted bilateral posterior putaminal presynaptic dopaminergic denervation. Post hoc analysis of MRI and SPECT fusion images confirmed bilateral posterior putamen lesions, with low signal intensity on DWI, confirming the diagnosis of postanoxic generalized dystonia.Conclusions: We report this case to highlight the utility of multimodal imaging in diagnosis of bilateral lesions in difficult neurologic disorders where there is discordance between the clinical presentation and morphological brain imaging.</description><subject>Adolescent</subject><subject>Basal ganglia</subject><subject>Basal Ganglia - diagnostic imaging</subject><subject>Basal Ganglia Diseases - diagnostic imaging</subject><subject>Bioengineering</subject><subject>Cardiology</subject><subject>Case reports</subject><subject>Diagnosis, Differential</subject><subject>Dystonia</subject><subject>Dystonic Disorders - diagnostic imaging</subject><subject>Dystonic Disorders - etiology</subject><subject>Ganglia</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Hypoxia, Brain - complications</subject><subject>Hypoxia, Brain - diagnostic imaging</subject><subject>Image of the Month</subject><subject>Imaging</subject><subject>Lesions</subject><subject>Life Sciences</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multimodal Imaging - methods</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Orthopedics</subject><subject>Psychiatrics and mental health</subject><subject>Radiology</subject><subject>Tomography, Emission-Computed, Single-Photon - methods</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU9v1DAQxS0EoqXwAbggS1zoIWA78Z9wW1WUVlqJC5wtOxkHV4692ElFvz1eUhYJiZOtmd97nvFD6DUl7ykh8kMhhPG-IVQ0bUfbRjxB51TQvpFE9U9Pd0nO0ItS7gihiqn-OTpjkkrFJDtH8TYukKEsODk8r2HxzZxGE7CfzeTjhH3E1gdToVoMUHyK5chaU2phMnEK3nzEOzyYAjjDIeXfXgYfUlkaE9NPP-DxoSwpevMSPXMmFHj1eF6gb9efvl7dNPsvn2-vdvtm6Lq-qsCCc9BZI0fe0XFoOwGWOceJkmqoXcM7YNKBUoZbEFZYZqkikgOn1rUX6HLz_W6CPuS6TH7QyXh9s9vrY43QVlLB-3ta2Xcbe8jpx1q_Qs--DBCCiZDWoqmiQrSMK1nRt_-gd2nNsW6iGWkVa3nH-krRjRpyKiWDO01AiT4Gp7fg6hBCH4PTomrePDqvdobxpPiTVAXYBpTaihPkv0__3_UXp9ejdA</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>David, Pierre-Maxime</creator><creator>Icard, Nicolas</creator><creator>Gauvrit, Jean-Yves</creator><creator>Vérin, Marc</creator><creator>Le Jeune, Florence</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Springer Verlag (Germany) [1976-....]</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-8057-6004</orcidid></search><sort><creationdate>20161001</creationdate><title>Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia</title><author>David, Pierre-Maxime ; Icard, Nicolas ; Gauvrit, Jean-Yves ; Vérin, Marc ; Le Jeune, Florence</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-aebeffe4ba7d541dc346eb2ff50878cebea54e27fe88a5be6b6b2b18075e51bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Basal ganglia</topic><topic>Basal Ganglia - diagnostic imaging</topic><topic>Basal Ganglia Diseases - diagnostic imaging</topic><topic>Bioengineering</topic><topic>Cardiology</topic><topic>Case reports</topic><topic>Diagnosis, Differential</topic><topic>Dystonia</topic><topic>Dystonic Disorders - diagnostic imaging</topic><topic>Dystonic Disorders - etiology</topic><topic>Ganglia</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Hypoxia, Brain - complications</topic><topic>Hypoxia, Brain - diagnostic imaging</topic><topic>Image of the Month</topic><topic>Imaging</topic><topic>Lesions</topic><topic>Life Sciences</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multimodal Imaging - methods</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Orthopedics</topic><topic>Psychiatrics and mental health</topic><topic>Radiology</topic><topic>Tomography, Emission-Computed, Single-Photon - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>David, Pierre-Maxime</creatorcontrib><creatorcontrib>Icard, Nicolas</creatorcontrib><creatorcontrib>Gauvrit, Jean-Yves</creatorcontrib><creatorcontrib>Vérin, Marc</creatorcontrib><creatorcontrib>Le Jeune, Florence</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>David, Pierre-Maxime</au><au>Icard, Nicolas</au><au>Gauvrit, Jean-Yves</au><au>Vérin, Marc</au><au>Le Jeune, Florence</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>43</volume><issue>11</issue><spage>2098</spage><epage>2099</epage><pages>2098-2099</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Objectives: We report the case of a 16-year-old patient with progressive generalized choreo-dystonia that appeared two months after a suicide attempt by hanging associated with a cardiorespiratory arrest. An initial magnetic resonance imaging (MRI) brain scan was judged normal by radiologists. Discordance between clinical presentation and morphological imaging led to the hypothesis of a psychogenic dystonia but striatal lesions were suspected by neurologists.Methods: A second MRI high field was performed and the patient also underwent 123I-fluopane single photon emission computed tomography (SPECT). MRI and SPECT fusion images were analysed.Results: The second MRI failed to reveal any lesions involving the basal ganglia. 123I-fluopane-SPECT, however, highlighted bilateral posterior putaminal presynaptic dopaminergic denervation. Post hoc analysis of MRI and SPECT fusion images confirmed bilateral posterior putamen lesions, with low signal intensity on DWI, confirming the diagnosis of postanoxic generalized dystonia.Conclusions: We report this case to highlight the utility of multimodal imaging in diagnosis of bilateral lesions in difficult neurologic disorders where there is discordance between the clinical presentation and morphological brain imaging.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27178272</pmid><doi>10.1007/s00259-016-3413-6</doi><tpages>2</tpages><orcidid>https://orcid.org/0000-0002-8057-6004</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Basal ganglia Basal Ganglia - diagnostic imaging Basal Ganglia Diseases - diagnostic imaging Bioengineering Cardiology Case reports Diagnosis, Differential Dystonia Dystonic Disorders - diagnostic imaging Dystonic Disorders - etiology Ganglia Human health and pathology Humans Hypoxia, Brain - complications Hypoxia, Brain - diagnostic imaging Image of the Month Imaging Lesions Life Sciences Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Multimodal Imaging - methods Nuclear Medicine Oncology Orthopedics Psychiatrics and mental health Radiology Tomography, Emission-Computed, Single-Photon - methods |
| title | Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia |
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