case_images: PMC5619109_01
case_images: [A,B] Axial T1-weighted magnetic resonance imaging shows
  symmetrical bilateral hyperintensities involving the substantia nigra
  (arrow in A), the anterior midbrain (curved arrow in A) and the globus
  pallidus (arrow in B). The putamen, caudate, thalamus (lines in B) and
  red nucleus (line in A) are spared. [C,D] Sagittal
  T1-weighted magnetic resonance imaging also demonstrates
  hyperintensities in the globus pallidus (arrow in C) and substantia
  nigra (arrow in D).
case_images: dn-06-01-0059-g01.jpg
case_images: PMC5619109_01_dn-06-01-0059-g01.jpg
case_images: f1
case_images: The putamen, caudate nucleus, thalamus, the red nucleus, and the cerebellum were spared (Figure 1). T2-weighted images disclosed small foci of hyperintensities in subcortical and deep white matter (not shown).
case_images: MR-spectroscopy. The main resonance peaks correspond to N-acetylaspartate
  (NAA, 2.0 ppm), glutamine glutamate (Glx, 2.1-2.5 ppm), creatine
  phosphocreatine (Cr, 3.02 ppm), choline-containing compounds (Cho, 3.2
  ppm), and myo-inositol (Ins, 3.55 ppm). The initial spectrum showed no
  increase in the glutamate glutamine region and a decrease in the
  myo-inositol and choline resonances.
case_images: dn-06-01-0059-g02.jpg
case_images: PMC5619109_01_dn-06-01-0059-g02.jpg
case_images: f2
case_images: MR -spectroscopy showed no anomalous peaks (Figure 2).