case_images: PMC5346942_01
case_images: a FLAIR MRI showing high signal in bilateral frontal and posterior deep white matter. b Coronal FLAIR image showing high signal in bilateral pyramidal tracts (arrows). c [123I]N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodophenyl) tropane single photon computed tomography (123I-FP-CIT SPECT) was normal.
case_images: crn-0009-0017-g01.jpg
case_images: PMC5346942_01_crn-0009-0017-g01.jpg
case_images: f1
case_images: BH4 8.4 g/day, levodopa 700 mg/day, 5-HTP 800 mg/day, entacapone 300 mg/day, folinic acid 15 mg/day, and levetiracetam 300 mg/day. Brain magnetic resonance imaging (MRI) showed high intensity areas in frontal and posterior deep white matter on fluid-attenuated inversion recovery (FLAIR) (Fig. 1a) and T2-weighted imaging. Coronal FLAIR image showed a high signal in bilateral pyramidal tracts (Fig. 1b). SPECT and [123I]N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodophenyl) tropane (123I-FP-CIT). 123I-FP-CIT SPECT was normal (Fig. 1c). Specific binding ratios were right 7.99 and left 8.13 (normal, >4.00).