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• ホーム
• 45巻4号
• 臨床神経, 45：312−316, 2005
• 45巻4号目次

症例報告

Ictal alteration of ^99mTc ECD SPECT imaging in a patient with secondary paroxysmal kinesigenic dyskinesia caused by hyperglycemia

Misuzu Saiki, Shinji Saiki, Yuichiro Gondo, Ken-ya Murata, Koichiro Sakai, Genjiro Hirose

Department of Neurology, Kanazawa Medical University [1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan]

We described a 61-year-old man with diabetes mellitus who presented with hyperglycemia related paroxysmal kinesigenic dyskinesia (PKD) with sudden development of paroxysmal unilateral involuntary movements (IMs) of his neck and the left extremities. Ictal ^99mTc-ethylcysteinate dimer SPECT (ECD-SPECT) revealed a hyperperfusion over the contralateral frontal cortex and a hypoperfusion over the contralateral basal ganglia. Immediate correction of hyperglycemia after admission resulted in a marked improvement of IMs and a return to normal cerebral blood flow on interictal ECD-SPECT imaging. These findings suggest that dysfunction of the indirect pathway through the basal ganglia lead to an imbalance of the cortico-striato-thalamo-cortical circuit and may have contributed to the cause of PKD in this case.

(臨床神経, 45：312−316, 2005)
key words：paroxysmal kinesigenic dyskinesia, nonketotic hyperglycemia, basal ganglia, motor association area, SPECT

（受付日：2004年11月26日）