engleski

TRANSCRANIAL SONOGRAPHY IN EVALUATION OF PATIENTS WITH MOVEMENT DISORDERS: 5 YEARS FOLLOW-UP STUDY

Purpose: Since there is no widely accepted test to help us confi rm Parkinson’s disease (PD) or essential tremor (ET), clinical examination of well- established symptoms is the still most accurate way of diagnosis. However, the misdiagnosis rates for PD and ET in the early stages is as high as 20-30% in PD and in about one of three patients in ET. We initiated this study to assess the usefulness of the transcranial sonography (TCS) in the evaluation and diff erential diagnosis of the patients with movement disorders, initialy and after 5 years follow up period. Methods: Our study was performed on 180 individuals, including 60 patients suff ering from ET, 60 PD patients, and 60 matched controls. TCS was applied by standardized protocol, SN was displayed, encircled, and measured two times. Mean area was calculated initially and after 5 years. Results: In the control group and PD group, bilateral combined mean SN size was 0.17 cm2 (±0.07) and 0.27 cm2 (±0.06), which showed signifi cant difference (p < 0.001). Patients with ET had mean SN size of 0.15 cm2 (±0.04), for the right side 0.15 cm2 (±0.04) and 0.16 cm2 (±0.05) for the left, which was signifi cantly diff erent from PD group (p < 0.001), but not from control group (p = 0.240). No signifi cant changes were found after follow up period. Conclusion: Our study confi rmed previous fi nding that SN hyperechogenicity in TCS is a highly specifi c fi nding of PD, which might help in confi rming PD diagnosis in doubtful clinical cases or in the early stages of the disease when symptoms of PD and ET might be overlapping. Also, after 5 years period SN fi nding did not diff ere, sugesting that SN hyperechogenicity is a stable PD marker.

parkinson disease; transcranial sonography; esential tremor

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