PO098 A lesson from the dat scan

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Abstract

Current diagnosis of Parkinson’s disease is clinical. A DaTscan may be helpful in complex cases. Both false positive DAT scan results (1.4%) and false negative (4.8%) are uncommon. We present a 50 year old woman who had a seven-year history of a right hand tremor, slowing, forgetfulness and hesitant speech. Past medical history included bipolar disorder (on lithium, haloperidol, valproate). There was some deliberate character of the movement during her initial assessment, thus a DAT scan was performed in assumption that it would be normal. The scan was however reported as abnormal. It was unclear if her parkinsonism was tardive parkinsonism or whever she had an underlying IPD or if it was caused by valproate. Therefore lithium, valproate and haloperidol were stopped with no improvement after eight months. Examination during follow up showed distractibility (complex tasks). We repeated a DAT scan (normal). A diagnosis of functional parkinsonism was made (the review of the original DAT scan subsequently revealed a normal scan). Functional parkinsonism can be difficult to distinguish from idiopathic PD in a well versed patient. DAT imaging can be helpful to distinguish the two; however a clinician should be vigilant and review the images if the diagnosis is in doubt.

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