Yoshii Fumihito, Moriya Yusuke, Ohnuki Tomohide, Takahashi Wakoh, Ryo Masafuchi
Department of Neurology, Tokai University Oiso Hospital, Oiso, Japan.
Case Rep Neurol. 2016 Dec 13;8(3):243-250. doi: 10.1159/000453254. eCollection 2016 Sep-Dec.
We report a 44-year-old female with striatonigral degeneration (SND) who showed wearing-off oscillations after 4 months of levodopa treatment. The patient presented with asymmetric left-side dominant rigidity, and levodopa was effective at first. However, she began to show wearing-off oscillations of motor symptoms, which gradually worsened thereafter. Fluid-attenuated inversion recovery sequence magnetic resonance imaging (MRI) showed linear lateral putamen hyperintensities, and positron emission tomography (PET) studies using F-fluorodopa (FD) and C-N-methylspiperon (NMSP) showed a marked decrease of radioactivity in the right putamen, especially in the posterior putamen. The results of MRI and 2 PET studies with FD and NMSP were well consistent with the diagnosis of SND.
我们报告了一名44岁患有纹状体黑质变性（SND）的女性，她在左旋多巴治疗4个月后出现剂末波动。患者表现为以左侧为主的不对称性强直，左旋多巴起初有效。然而，她开始出现运动症状的剂末波动，此后逐渐加重。液体衰减反转恢复序列磁共振成像（MRI）显示壳核外侧呈线性高信号，使用F-氟多巴（FD）和C-N-甲基螺哌隆（NMSP）的正电子发射断层扫描（PET）研究显示右侧壳核放射性明显降低，尤其是壳核后部。MRI以及FD和NMSP的两项PET研究结果与SND的诊断高度一致。
