Akinetic Mutism in a Bone Marrow Transplant Recipient Following Total-Body Irradiation and Amphotericin B Chemoprophylaxis
- 1 April 1987
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Neurology
- Vol. 44 (4), 414-417
- https://doi.org/10.1001/archneur.1987.00520160048013
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.This publication has 17 references indexed in Scilit:
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