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題 名 | Dopamine Deficiency in Rubral Tremor Caused by Midbrain Hemangioma: Case Report=多巴胺缺乏與紅核顫抖症(Rubral Tremor):病例報告 |
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作 者 | 翁意欣; 高潘福; 蔡崇豪; 閻紫宸; 陸清松; | 書刊名 | 長庚醫學 |
卷 期 | 23:8 2000.08[民89.08] |
頁 次 | 頁485-491 |
分類號 | 415.641 |
關鍵詞 | 中腦血管瘤; 紅核顫抖症; 多巴胺轉運體; 單光子射出攝影; Midbrain hemangioma; Rubral tremor; Dopamine transporter; Single photon emission computed tomography; SPECT; |
語 文 | 英文(English) |
英文摘要 | To elucidate the nigrostriatal involvement in rubral tremor, we studied single photon emission computed tomography (SPECT) imaging with [2-[[2-[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3.2.1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N2,,S2,S2,]oxo-[1R-(exo-exo)]-[99mTc]technetium ([99mTc]TRODAT-1) in a 70-year-old woman with a midbrain hemangioma. She had developed a slow tremor in her right arm and leg after an episode of hemorrhage at the age of 28. The tremor was 3 to 5 Hz in frequency at rest, which was enhanced by outstretching the limb and action. There was no rigidity or bradykinesia. Neurological examination also revealed mild palsy of the left oculomotor nerve. The magnetic resonance imaging (MRI) of the brain showed a small hemangioma in the left midbrain localized mainly in the substantia nigra. The [99mTc]TRODAT-1 SPECT imaging revealed significantly reduced [99mTc]TRODAT-1 uptake in the left caudate and putamen, but it was only mildly reduced in the right striatum. This reduction in uptake was even more severe than that of patients with Parkinson's disease, and indicated that the dopamine function was markedly impaired in the left nigrostriatal system. The tremor had not progressed over the years, and she responded moderately to treatment with levodopa. We concluded that the rubral tremor in the right extremities was probably caused by a dopamine deficiency in the left nigrostriatal system. This suggests that a dopamine deficiency secondary to the midbrain hemangioma might have contributed to the development of the rubral tremor in this patient. |
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