Diffusion-Weighted MRI discriminates Parkinson´s Disease from the Parkinsonian Variant of Multiple System Atrophy: a Meta-analysis
Objective: A systematic review and meta-analysis was performed to evaluate the diagnostic accuracy of DWI in the differential diagnosis of the parkinsonian variant of multiple…A case report: a primary progressive multiple sclerosis (PPMS) with adolescent-onset of progressive cerebellar ataxia
Objective: To report a 26 year-old female with progressive cerebellar ataxia for 12 years diagnosed to have primary progressive multiple sclerosis (PPMS). Background: Multiple sclerosis (MS) is a kind of CNS demyelinating disease. About 15% MS patients have a progressive course without a relapsing course. These patients are considered to have PPMS. It often presented a progressive neurological problem--such as lateralizing weakness, or numbness in the legs. Cerebellar ataxia as primary symptom is less frequent in PPMS and it's usually diagnosed in their 40-60 years at age. Here we present a case with adolescent-onset PPMS presenting progressive cerebellar ataxic syndrome. Methods: A 26 year-old female Taiwanese presented with 12 years of progressive ataxic gait. She denied relapses and remissions of symptoms. There were no mental decline, involuntary movements, muscle hypertrophy or abnormality in hearing or vision. She had no associated family history or consanguineous parents. Physical examination revealed dysarthria, dysmetria/intentional tremor and dysdiadochokinesia in four limbs and bilateral extensor plantar response. In addition, she had normal tendon reflexes, intact sensory function and negative Romberg test without parkinsonian features. Her gait was wide-based. Results: On investigation, CBC, lipid profile, LFT, chest X-ray, serum electrolytes, ECG, EEG and NCV showed normal results. VEP study were abnormal. The brain and cervical spine MRI showed no significant cerebellar atrophy or myelopathy. Instead, FLAIR-weighted imaging showed diffuse plaques in brainstem and cerebral white matters with a predilection for periventricular white matter with the major axes perpendicular to the ventricular surface (Dawson’s fingers). Besides, the CSF study revealed oligoclonal banding and elevation of IgG index. She had normal serum copper and ceruloplasmin levels and plasma very long-chain fatty acids (VLCFA) analysis. The genetic testing for spinocerebellar ataxia ( SCA1, 2, 3, 6, 7 and 17) is negative. In view of progressive ataxia with diffuse white matter lesions, a diagnosis of PPMS was made. Conclusions: PPMS can be a etiology in adolescent patient with progressive ataxic syndrome. Brain MRI is a better tool for detecting cerebral white matter lesions compared to CT in differential diagnosis of progressive ataxia. References:…Brain iron accumulation in Wilson disease measured by quantitative susceptibility mapping
Objective: To investigate whether cerebral iron deposits in Wilson disease (WD) patients are associated with decreased serum ceruloplasmin oxidase activity and/or clinical severity. Background:…Longitudinal white matter microstructural change in Parkinson’s disease
Objective: To map regional differences in rates of change in diffusion tensor imaging (DTI)-based measures of brain white matter microstructural integrity between Parkinson (PD) patients and…Assessment of substantia nigra degeneration with magnetic resonance and transcranial ultrasonography
Objective: Our objective was to assess both exploration techniques in patients with initial IPD and verify the concordance of the findings, thus positioning them as…Differentiating Parkinsonism with Spatio-temporal dynamics (real-time MRI) and Acoustics of Speech (spectrogram)
Objective: Differentially diagnosing subgroups in Parkinsonism for optimal rehabilitation thus designed study with real-time dynamic magnetic resonance imaging (MRI) and automated acoustic analysis Background: In Parkinsonism with…Non-Progressive Coreoatethosis Secondary to Infantile Necrotizing Encephalopathy Mimicking Leigh Disease.
Objective: Our objective is to report image findings of an acute necrotizing encephalopathy of childhood (ANEC) in a 15 years-old girl, completely normal until 18…Unusual MRI findings of the syndrome of acute bilateral basal ganglia lesions in diabetic uremia with hyperglycemia associated dyskinesia
Objective: To describe the unusual image findings and clinical manifestations of the syndrome of acute bilateral basal ganglia lesions in a diabetic uremic patient with…Action Observation Training Effects on Brain Structural and Functional Changes in Parkinson’s Disease Patients
Objective: To assess brain functional and structural changes following action observation training (AOT) associated with exercises of balance, gait, transfers and manual dexterity in Parkinson’s…The Role of MRI and DaTscan in Vascular Parkinsonism: A Case Report
Objective: The role of MRI and DAT scan in Vascular Parkinsonism: A Case Report Background: DaTscan has become a widely used clinical tool to help clinicians…
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