RESUMO
There is evidence suggesting that muscarinic cholinergic neuroreceptors (mChR) are reduced at seizure foci. Iodine-123 (I-123) iododexetimide (IDEX) single-photon emission computed tomography (SPECT) permits in vivo imaging of mChR. We assessed 23 patients with temporal lobe epilepsy (TLE) undergoing preoperative assessment. Regions of interest were placed over the amygdala, hippocampus, and lateral temporal cortex on IDEX SPECT images. Eighteen patients had unilateral TLE. In these, IDEX binding in the ipsilateral hippocampal region was reduced by 19.1 +/- 12%. This was significantly greater than blood flow asymmetry (p < 0.02 by Wilcoxon's signed-rank test). Changes were less marked in the amygdala (11.3 +/- 6.4%) and lateral cortex (7.6 +/- 12.1%). Blinded visual analysis gave correct localization in 14 (78%) patients, and hexamethylpropylenamine oxide (HMPAO) SPECT gave correct localization in 50%. MRI revealed hippocampal sclerosis in 13 (72%) patients and was normal in 5 patients. Of the latter group, four were correctly localized by IDEX. This study confirms that mChR receptors are altered in medial temporal lobe structures in TLE. IDEX SPECT appears to be superior to interictal HMPAO SPECT and complimentary to MRI for seizure focus localization.
Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Receptores Colinérgicos/metabolismo , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Feminino , Humanos , Radioisótopos do Iodo , MasculinoRESUMO
We describe hyperparathyroidism in an 18-year-old man with Wilson's disease--the first report in the English literature of the simultaneous occurrence of these two conditions.
Assuntos
Degeneração Hepatolenticular/complicações , Hiperparatireoidismo/complicações , Adenoma/complicações , Adolescente , Densidade Óssea , Cálcio/sangue , Cálcio/urina , Ceruloplasmina/metabolismo , Cobre/urina , Degeneração Hepatolenticular/metabolismo , Degeneração Hepatolenticular/terapia , Humanos , Hiperparatireoidismo/metabolismo , Hiperparatireoidismo/terapia , Transplante de Fígado , Masculino , Glândulas Paratireoides/cirurgia , Neoplasias das Paratireoides/complicações , Albumina Sérica/metabolismoRESUMO
A retrospective review of 4023 thyroid scans performed at the Royal Adelaide Hospital in the five years to February 1987 identified 105 cases of subacute thyroiditis. Subacute thyroiditis accounted for 9.9% of subjects scanned for hyperthyroidism. Eighty-four percent had painful thyroiditis, 6% postpartum thyroiditis, and 10% painless thyroiditis. Follow-up was obtained in 68% of cases, and 11% were taking thyroxine, probably indicating long-term hypothyroidism. Apart from the presence of antibodies in post-partum thyroiditis, no other factor was identified which predicted the development of long-term hypothyroidism. As subacute thyroiditis is a common cause of hyperthyroidism in our community, the authors believe all people with hyperthyroidism should have a thyroid scan unless they have distinctive features of Graves' disease.
