0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Observation |

Enteroviral Postencephalitic Parkinsonism With Evidence of Impaired Presynaptic Dopaminergic Function

Michel Toledano, MD1,2; Nicholas W. S. Davies, PhD, FRCP2
[+] Author Affiliations
1Department of Neurology, Mayo Clinic, Rochester, Minnesota
2Department of Neurology, Charing Cross Hospital, Imperial College Healthcare National Health Service Trust, London, England
JAMA Neurol. 2016;73(8):1023-1025. doi:10.1001/jamaneurol.2016.1043.
Text Size: A A A
Published online

Extract

This case report describes a woman with enteroviral postencephalitic parkinsonism with impaired presynaptic dopaminergic function.

Postencephalitic parkinsonism is reported following infection with certain viruses such as Japanese B encephalitis virus, St Louis encephalitis virus, western equine encephalitis virus, eastern equine encephalitis virus, West Nile virus, Epstein-Barr virus, influenza A virus, and certain enteroviruses such as coxsackievirus B and echoviruses.1 These viruses affect the cortex, thalamus, brainstem, and spine, but preferential involvement of the substantia nigra (SN) has been reported.1,2 Postencephalitic parkinsonism with SN involvement has also been reported in cases of encephalitis lethargica (EL; von Economo disease),3,4 which occurred in epidemic form between 1915 and 1928. To our knowledge, although a viral etiology has long been suspected in EL, no infectious agent has ever been isolated.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.
Magnetic Resonance Imaging (MRI) and Dopamine Transporter Scan Imaging

A, Coronal fluid-attenuated inversion recovery MRI 3 days after presentation showing signal change extending caudally from the midbrain to the pons. B, T2-weighted axial MRI 15 days later showing overall improvement and maturation of signal in the substantia nigra (SN), right (arrowhead) greater than left. C, T2-weighted axial MRI at 1 year demonstrating gliotic changes in the SN, right (arrowhead) greater than left. D, T2-weighted axial MRI demonstrating subtle signal abnormality in the bilateral basal ganglia at presentation. E, T2-weighted axial MRI showing no appreciable evolution or radiologic evidence of tissue destruction at 1 year. F and G, Dopamine transporter scan 3 weeks (F) and 1 year (G) after presentation showing reduced uptake in the right putamen and in the right greater than left putamen, respectively.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

188 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();