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Cervical MRI of subacute myelo-optico-neuropathy.
MedLine Citation:
PMID:  20548321     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Study design:Case study.Objectives:Subacute myelo-optico-neuropathy (SMON) is a severe neuro-degenerative disorder caused by poisoning due to over-dose and prolonged oral administration of clioquinol; this disorder was more frequent during 1957-1970. It is characterized by axonal degeneration and gliosis in the cervical gracile fasciculus. Recently, copper-deficient myelo-neuropathies presenting similar symptoms (that is, painful dysesthesia/paresthesia in the lower limbs, ataxia, spastic paraplegia, autonomic disorders and visual impairment) were reported. Magnetic resonance imaging (MRI) of these patients detected T2-weighted hyperintensities in the cervical spinal cord. An unbalanced zinc-copper metabolism was suggested as one of the candidate pathogenesis of clioquinol toxicity because of its metal-chelating ability. The aim of this study was to present MRI findings of old SMON patients and to compare them with those of current copper-deficient myelo-neuropathies.Setting:Japan.Methods:We conducted and analyzed cervical and brain MRIs of seven old SMON patients who contracted the disorder during the 1960s. Serum iron, magnesium, copper, zinc and ceruloplasmin levels were also measured.Results:Cervical T2-weighted MRIs showed mild volume loss and faint hyperintensities in the dorsal columns, which might reflect residual gliosis. Brain fast fluid-attenuated inversion-recovery images and tractography were normal. Current levels of serum copper and zinc were within almost normal ranges.Conclusion:Although fainter, the abnormal T2 MRI signals we observed were similar to and occurred in the same locations as those reported in copper-deficient myelo-neuropathy patients. We suggest that these findings are useful to study the mechanism of clioquinol toxicity before using it to treat neurodegenerative diseases such as Alzheimer's disease.
Authors:
E Kimura; T Hirano; S Yamashita; T Hirai; Y Uchida; Y Maeda; M Uchino
Publication Detail:
Type:  Journal Article     Date:  2010-06-15
Journal Detail:
Title:  Spinal cord : the official journal of the International Medical Society of Paraplegia     Volume:  49     ISSN:  1476-5624     ISO Abbreviation:  Spinal Cord     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  182-5     Citation Subset:  IM    
Affiliation:
Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
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