Akinetic mutism in a bone marrow transplant recipient following total-body irradiation and amphotericin B chemoprophylaxis: A positron emission tomographic and neuropathologic study Journal Article

  

Authors:	Devinsky, O.; Lemann, W.; Evans, A. C.; Moeller, J. R.; Rottenberg, D. A.
Article Title:	Akinetic mutism in a bone marrow transplant recipient following total-body irradiation and amphotericin B chemoprophylaxis: A positron emission tomographic and neuropathologic study
Abstract:	We describe a case of akinetic mutism associated with diffuse cerebral leukoencephalopathy, which developed in a bone marrow transplant recipient following total-body irradiation and amphotericin B chemoprophylaxis. A trial of high-dose bromocriptine did not stimulate purposeful verbal or motor activity. Fluorine 18-fluorodeoxyglucose positron emission tomographic studies, performed before and during bromocriptine therapy, demonstrated cerebral hypometabolism and treatment-related decreases in regional cerebral blood volume. We conclude that whole-brain or total-body irradiation may increase blood-brain barrier permeability to polyene antibiotics, and that high-dose therapy with dopamine agonists is unlikely to benefit patients with akinetic mutism due to diffuse whitematter lesions. © 1987, American Medical Association. All rights reserved.
Keywords:	adult; case report; neurotoxicity; positron emission tomography; central nervous system; whole body radiation; diagnosis; fluorodeoxyglucose f18; glucose; radioisotope; drug therapy; bone marrow transplantation; brain blood flow; cerebrovascular circulation; adverse drug reaction; therapy; leukoencephalopathy; intravenous drug administration; aplastic anemia; whole-body irradiation; tomography, emission-computed; nervous system; bromocriptine; intoxication; amphotericin b; deoxyglucose; anemia, aplastic; akinetic mutism; humans; human; male; priority journal; blood and hemopoietic system; peripheral vascular system
Journal Title:	Archives of Neurology
Volume:	44
Issue:	4
ISSN:	0003-9942
Publisher:	American Medical Association
Date Published:	1987-04-01
Start Page:	414
End Page:	417
Language:	English
DOI:	10.1001/archneur.1987.00520160048013
PUBMED:	3548667
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0023110558&doi=10.1001%2farchneur.1987.00520160048013&partnerID=40&md5=16d7d1a91dce85ab41b7debc8544fd0f
Notes:	Article -- Export Date: 5 February 2021 -- Source: Scopus; Acknowledgements: We wish to thank Maria Sergi for assistance with data analysis and Adele Ahronheim for manuscript preparation.

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