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We report 2 patients with neurological sequelae of oral cyanide intoxication who were evaluated clinically and neuropsychologically with high-resolution magnetic resonance imaging and one of them with positron emission tomography.The clinical syndrome was characterized by extrapyramidal motor and cerebellar symptoms such as bradykinesia, hypomimia,slowed speech,anteropulsion,and marked retropulsion,but little tremor.The sensory and pyramidal motor systems were normal or relatively spared.On neuropsychological testing the intellectual capacity and memory functions were normal,whereas the speed of motor reaction and verbal fluency were reduced.Magnetic resonance imaging showed damage of the globus pallidus,putamen,substantia nigra,subthalamic nucleus,and cerebellum in both patients,whereas the sensory-motor cortex and hippocampus were relatively spared.F-6-Fluro-dopa positron emission tomography revealed a symmetrical reduction of striatal dopa uptake by 42% on average that was similar in the putamen and caudate.F-2-Fluro-2- deoxyglucose positron emission tomography showed a regional reduction of the glucose metabolism in the posterior putamen and temporo-parieto- occipital and cerebellar cortex. |
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basal ganglia,lesion of
CAT scan,emission
CAT scan,emission,abnormal
cyanide poison
globus pallidus,lesion of
globus pallidus,lesion of,bilateral
MRI
MRI,abnormal
Parkinson disease
Parkinsonism syndrome
psychological testing
putamen,lesion of
substantia nigra
suicide
toxins,nervous system
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