Objective: The aim of our work was to assess the diagnostic impact of 123-I Ioflupane SPECT in patients with tremor and some other sign of Parkinsonisms in regards to its categorization in Parkinsonisms with involvement/indemnity of presynaptic dopaminergic neurons as well as to establish a differential diagnosis between essential tremor (ET) and degenerative Parkinsonism.
Methods: 105 patients were included, 45 for differential diagnosis between Parkinsonism and ET, 52 to determine the origin of their Parkinsonism (degenerative vs secondary) and 8 with an established diagnosis, 5 Parkinson's disease and 3 ET. A dose of 185 MBq of Ioflupane 1-123 was administered and tomographic study acquired at 5 hours. After reconstruction, transaxial views were assessed by three observers. In all the patients, the diagnosis was established by a neurologist specialized in movement disorders, according to the symptoms, course, response to treatment and result of Ioflupane I-123.
Results: 42 patients were diagnosed of degenerative Parkinsonism (PD or Parkinsonism plus) and 63 of ET or secondary Parkinsonism. We obtained a values of sensitivity, specificity, PPV, NPV and accuracy of 93 %, 100 %, 100 %, 97 % and 97 % respectively. 123-I Ioflupane SPECT changed the treatment in 18 % of our patients.
Conclusions: 123-I Ioflupane SPECT is a test of great value to establish the differential diagnosis between Parkinsonism vs ET and secondary vs degenerative Parkinsonism.