Dierckx R A, Saerens J, De Deyn P P, Verslegers W, Marien P, Vandevivere J
Department of Nuclear Medicine, A.Z.-Middelheim, Antwerp, Belgium.
J Nucl Med. 1991 Aug;32(8):1619-21.
A 78-yr-old woman presented with transient echolalia and palilalia. She had suffered from Parkinson's disease for 2 yr. Routine laboratory examination showed hypotonic hyponatremia, but was otherwise unremarkable. Brain mapping revealed a bifrontal delta focus, more pronounced on the right. Single photon emission computed tomography (SPECT) of the brain with technetium-99m labeled d,l hexamethylpropylene-amine oxime (99mTc-HMPAO), performed during the acute episode showed relative frontoparietal hypoactivity. Brain mapping performed after disappearance of the echolalia and palilalia, which persisted only for 1 day, was normal. By contrast, SPECT findings persisted for more than 3 wk. Features of particular interest in the presented patient are the extensive defects seen on brain SPECT despite the absence of morphologic lesions, the congruent electrophysiologic changes and their temporal relationship with the clinical evolution.
一名78岁女性出现短暂的模仿言语和重复言语。她患帕金森病已有2年。常规实验室检查显示低渗性低钠血症，但其他方面无异常。脑图谱显示双额叶δ波灶，右侧更明显。在急性发作期间进行的用锝-99m标记的d，l-六甲基丙烯胺肟（99mTc-HMPAO）脑单光子发射计算机断层扫描（SPECT）显示额顶叶相对活动减退。模仿言语和重复言语仅持续1天消失后进行的脑图谱检查正常。相比之下，SPECT结果持续了3周多。该患者特别值得关注的特征是尽管没有形态学病变，但脑SPECT上仍出现广泛缺损、一致的电生理变化及其与临床演变的时间关系。
