Figure 1
Structural and Functional Imaging of the Patient’s Brain. Brain MRI nonenhanced T2 FLAIR images acquired 4 months (A) and 12 months (B) after initial symptom showed marked striatal hyperintensity and striatal atrophy, respectively, and FP-CIT PET scan showed a decrease in DAT binding in the bilateral striatum (C). Abbreviations: [18F] N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography (PET); DAT, Dopamine Active Transporter; FLAIR, Fluid Attenuated Inversion Recovery; MRI, Magnetic Resonance Imaging.
Video 1
Before Intravenous Amantadine Treatment. Chorea mainly involving the face, neck, and both upper extremities, with mild involvement of the lower extremities while sitting down with feet touching the floor is observed. Slight loss of balance and augmentation of chorea is noted when performing the pull-test. Wide-based choreiform gait with irregular step length differential is seen during free gait.
Video 2
After Intravenous Amantadine Treatment. Partial improvement of chorea involving the face, neck, and both the upper extremities and some restoration in gait and postural balance is observed. At follow-up interview on symptoms, the patient reported improvement in using spoon while eating and in gait.