Abstract
Diagnosis of Parkinson's disease can be difficult in presence of atypical symptoms and signs. While the commonest reason of parkinsonism is idiopathic Parkinson's disease (PD), other disease entities that can mimic PD should be considered in the light of clinical history and examination findings. However, still some diagnostic dilemmas may exist which may need special investigative modalities. In recent years, advancements have been made to use single proton emission computed tomography (SPECT) scan to determine the cause of parkinsonian features. However, clinical use of this specialized tool is still not well-recognized. We have presented here a case of supranuclear palsy that was difficult to diagnose clinically and had appropriate final diagnosis with the help of dopamine transporters (DaT) scan.
Highlights
Diagnosis of Parkinson's disease can be difficult in presence of atypical symptoms and signs
Advancements have been made with regards to use of single proton emission computed tomography (SPECT) scan to determine the cause of parkinsonian features
We have presented here a case of progressive supranuclear palsy that was difficult to diagnose clinically and had appropriate final diagnosis with the help of dopamine transporters (DaT) scan
Summary
Diagnosis of Parkinson's disease can be difficult in presence of atypical symptoms and signs. We have presented here a case of progressive supranuclear palsy that was difficult to diagnose clinically and had appropriate final diagnosis with the help of dopamine transporters (DaT) scan. Chest X-ray, CT brain scan and subsequent MRI of the brain were reported as normal. At this point, the differential diagnoses included drug-induced Parkinsonism, idiopathic Parkinson's disease (PD), essential tremor, or Parkinson's Plus Syndrome. A 123I FP-b-CIT SPECT dopamine transporter scan (Figure 1) was done It showed bilateral reduced uptake of tracer.
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