Distinct basal ganglia hyperechogenicity in idiopathic basal ganglia calcification

Authors

  • Norbert Brüggemann MD,

    1. Schilling Section of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany
    2. Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Susanne A. Schneider MD, PhD,

    1. Schilling Section of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany
    2. Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Thurid Sander MD,

    1. Schilling Section of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany
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  • Christine Klein MD,

    1. Schilling Section of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany
    2. Department of Neurology, University of Lübeck, Lübeck, Germany
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  • Johann Hagenah MD

    Corresponding author
    1. Schilling Section of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany
    2. Department of Neurology, University of Lübeck, Lübeck, Germany
    • Department of Neurology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
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  • Potential conflict of interest: Nothing to report.

Abstract

We report a 67-year-old patient with idiopathic basal ganglia calcification (IBGC). He presented with progressive cognitive impairment, frontal lobe dysfunction, mild leg spasticity, and levodopa (L-dopa)-responsive parkinsonism. Transcranial sonography (TCS) revealed marked hyperechogenicity of the basal ganglia and periventricular spaces bilaterally. The detected signal alterations showed a fairly symmetric distribution and corresponded to the hyperintense calcifications depicted on the computer tomography brain scan. The combination of symmetric hyperechogenic areas adjacent to the lateral ventricles and of the basal ganglia may serve as an imaging marker characteristic of IBGC. Hyperechogenicity due to extended basal ganglia calcification as presented here is distinct from the pattern of hyperechogenicity caused by heavy metal accumulation, which is described to be less striking. In addition to atypical parkinsonian syndromes such as progressive supranuclear palsy and multiple system atrophy, IBGC is thus another differential diagnosis of parkinsonism with basal ganglia hyperechogenicity. © 2010 Movement Disorder Society.

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