18F]FDOPA PET and clinical features in parkinsonism due to manganism. |
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Authors: | Brad A Racette Jo Ann Antenor Lori McGee-Minnich Stephen M Moerlein Tom O Videen Vikas Kotagal Joel S Perlmutter |
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Institution: | Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. racetteb@neuro.wustl.edu |
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Abstract: | Manganese exposure reportedly causes a clinically and pathophysiologically distinct syndrome from idiopathic Parkinson's disease (PD). We describe the clinical features and results of positron emission tomography with 6-18F]fluorodopa (18F]FDOPA PET) of a patient with parkinsonism occurring in the setting of elevated blood manganese. The patient developed parkinsonism associated with elevated serum manganese from hepatic dysfunction. 18F]FDOPA PET demonstrated relatively symmetric and severely reduced 18F]FDOPA levels in the posterior putamen compared to controls. The globus pallidum interna had increased signal on T1-weighted magnetic resonance imaging (MRI) images. We conclude that elevated manganese exposure may be associated with reduced striatal 18F]FDOPA uptake, and MRI may reveal selective abnormality within the internal segment of the pallidum. This case suggests that the clinical and pathophysiological features of manganese-associated parkinsonism may overlap with that of PD. |
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Keywords: | Parkinson's disease manganese PET |
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