DaTSCAN
Clinical Details - Case 3
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Question 1
Is prescan preparation is required?
Answer
Yes, thyroid blockade. 170 mg potassium iodate is take 20 minutes pre and 24 hours post injection. Several drugs should also be stopped prior to undergoing a DaTSCAN, two of the more common ones are buscopan and fentanyl.
Question 2
Can a DaTSCAN differentiate between Idiopathic Parkinson's Disease (IPD) and DaTSCAN's Plus Syndromes?
Answer
No, as the DaTSCANian syndromes (multisystem atrophy, progressive supranuclear palsy, and corticobasal system degeneration) also have a deficit in presynaptic dopaminergic terminals. It helps differentiates between IPD and Essential Tremor as the latter is not associated with pathology in the nigro-striatal pathway. Lewy Body Dementia cannot be differentiated form IPD, these two entities may represent two ends of a disease spectrum.
Question 3
Can a DaTSCAN differentiate between Idiopathic Parkinson's Disease (IPD) and Drug Induced DaTSCANism.?
Answer
Yes. Drug induced DaTSCANism is largely due to neuroleptics which act by blocking the D2 receptor which are located predominantly on the post synaptic neurons, therefore leaving the presynaptic receptors unaffected and consequently a normal DaTSCAN appearance.
Question 4
Is the above DaTSCAN normal or abnormal?
Answer
Abnormal. There is reduced specific tracer binding in the left putamen. This is the typical finding early in the disease ie reduced tracer uptake in the putamen contralateral to the affected limb leaving visualization of the caudate nucleus only on this side.
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The text is entirely the opinion of the author and does not necessarily reflect that of RUH NHS Trust or the Bristol Radiology Training Scheme. Website content devised by Paul McCoubrie.