ABSTRACT
Head trauma has been mentioned as an uncommon cause of secondary Parkinsonism. We report a 68-year-old woman who developed a rapidly evolving post-traumatic encephalopathy with predominant akinetic-rigid syndrome. The clinical manifestations were mainly bradykinesia, rigidity, cognitive dysfunction and emotional lability. Brain SPECT showed perfusion defect in the left basal ganglia and thalamus. The parkinsonian symptoms improved moderately with levodopa.
Subject(s)
Aged , Female , Humans , Basal Ganglia , Brain Injuries , Brain , Craniocerebral Trauma , Hypokinesia , Levodopa , Parkinson Disease, Secondary , Parkinsonian Disorders , Perfusion , Thalamus , Tomography, Emission-Computed, Single-PhotonABSTRACT
CHAP syndorme consists of choreoathetosis, orofacial dyskinesia, affective change, hypotonia, and pseudobulbar signs. CHAP syndrome was firstly des- cribed with onset 1 to 7 days after induced profound hypothermia and complete circulatory arrest for con- genital heart lesion repair. Since then, only a few cases have been reported until now. Case We report a patient who demonstrated all of the elements of the CHAP syndrome in severe cachexic state. Brain SPECT(99mTC-ECD) shows decreased perfusion in left fronto-parieto-temporal lobe. Comments The pathogenesis of CHAP syndrome is obscure. However our case led us to suggest that more essential component pre- disposing to the CHAP syndrome is hypoxia rather than hypothermia. Furthermore, it seems to be related with circulatory insufficiency in extrapyramidal nervous systems.