Zaknun John J, Stieglbauer Karl, Trenkler Johannes, Aichner Franz
Department of Neurology, Division of Neuronuclear Medicine and Institute of Neuroradiology, Wagner-Jauregg Hospital, A-4020 Linz, Austria.
Parkinsonism Relat Disord. 2005 Mar;11(2):125-9. doi: 10.1016/j.parkreldis.2004.07.013.
A 35-year-old female ingested a lethal dose of potassium cyanide in a suicide attempt. She survived following antidote therapy and intensive care. Following artificial coma she presented with an agitative state for several days followed by akinetic mutism, buccofacial and ideomotoric aphasia. Severe rigid-akinetic syndrome, dysarthria, dysphagia and generalized dystonia developed weeks later. MRI revealed lesions in the caudate and lentiform nuclei, precentral cortex, and cerebellum. SPECT by [123-I] 2 beta-carbomethoxy-3-beta-(4-iodophenyl)-Tropan on two occasions revealed progressive loss of dopamine transporter suggestive of nigral neuronal apoptosis. Striatal and frontal hypometabolism and hypoperfusion were found by FDG-PET and HMPAO SPECT.
一名35岁女性为自杀吞服了致死剂量的氰化钾。经解毒治疗和重症监护后她存活下来。在人工昏迷后，她出现了数天的激越状态，随后发展为运动不能性缄默症、口面部及观念运动性失语。数周后出现严重的强直 - 运动不能综合征、构音障碍、吞咽困难和全身性肌张力障碍。MRI显示尾状核、豆状核、中央前回皮质和小脑有病变。两次使用[123-I] 2β - 甲氧羰基 - 3β - (4 - 碘苯基) - 托烷进行单光子发射计算机断层扫描（SPECT）显示多巴胺转运体逐渐丧失，提示黑质神经元凋亡。通过氟代脱氧葡萄糖正电子发射断层扫描（FDG - PET）和六甲基丙烯胺氧（HMPAO）SPECT发现纹状体和额叶代谢减低及灌注不足。
