{"id":339558,"date":"2017-07-23T02:00:00","date_gmt":"2017-07-23T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/manifestations-typiques-des-syndromes-parkinsoniens-atypiques\/"},"modified":"2017-07-23T02:00:00","modified_gmt":"2017-07-23T00:00:00","slug":"manifestations-typiques-des-syndromes-parkinsoniens-atypiques","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/fr\/manifestations-typiques-des-syndromes-parkinsoniens-atypiques\/","title":{"rendered":"Manifestations typiques des syndromes parkinsoniens atypiques"},"content":{"rendered":"<p><strong>Dans les syndromes parkinsoniens atypiques, l&#8217;imagerie montre souvent des motifs charact\u00e9ristiques qui permettent une attribution diganostique. Ces mod\u00e8les d&#8217;infestation portent souvent des noms \u00e9vocateurs.<\/strong><\/p>\n<p><!--more--><\/p>\n<p><strong>Introduction :<\/strong> Dans les &#8220;syndromes parkinsoniens atypiques&#8221; (\u00e9galement appel\u00e9s &#8220;Parkinson Plus&#8221;), d&#8217;autres syst\u00e8mes du cerveau sont affect\u00e9s tr\u00e8s t\u00f4t, en plus des neurones dopaminergiques de la substantia nigra. Alors que ces maladies permettent g\u00e9n\u00e9ralement d&#8217;\u00e9tablir des diagnostics cliniques clairs aux stades ult\u00e9rieurs, il est parfois difficile de les distinguer de la maladie de Parkinson idiopathique aux stades ant\u00e9rieurs ou en cas d&#8217;\u00e9volution atypique. En raison de l&#8217;atrophie avanc\u00e9e de zones circonscrites du SNC, l&#8217;imagerie montre souvent des motifs caract\u00e9ristiques qui permettent une attribution diagnostique pr\u00e9cise. Le nom de ces mod\u00e8les d&#8217;infestation est tr\u00e8s clair et facile \u00e0 retenir.<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\" size-full wp-image-8927\" alt=\"\" src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/kolibri_broetchen.jpg\" style=\"height:438px; width:200px\" width=\"592\" height=\"1296\"><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Description du cas : <\/strong>Les deux patients pr\u00e9sent\u00e9s ici \u00e9taient suspect\u00e9s d&#8217;avoir un syndrome parkinsonien atypique avec tremblements et instabilit\u00e9 de la marche. L&#8217;atrophie multisyst\u00e9mique (MSA) d\u00e9signe une maladie neurod\u00e9g\u00e9n\u00e9rative sporadique caract\u00e9ris\u00e9e par des sympt\u00f4mes de la maladie de Parkinson (MSA-P), une ataxie c\u00e9r\u00e9belleuse (MSA-C) ou des d\u00e9ficits autonomes (MSA-A). La sous-classification d\u00e9pend de la symptomatologie dominante.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8928 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/617;height:337px; width:600px\" width=\"1100\" height=\"617\" data-srcset=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0.jpg 1100w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-800x449.jpg 800w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-120x67.jpg 120w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-90x50.jpg 90w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-320x179.jpg 320w, https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb1_np4_s20_0-560x314.jpg 560w\" data-sizes=\"(max-width: 1100px) 100vw, 1100px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>La MSA-C, en particulier, pr\u00e9sente un tableau caract\u00e9ristique d&#8217;atrophie exclusivement infratentorielle du pons et du cervelet. Les clich\u00e9s sagittaux montrent une nette atrophie du pons (fl\u00e8ches en  <strong>Fig.&nbsp;1b)<\/strong>  et du cervelet avec une fissure primaire \u00e9largie (fl\u00e8che \u00e9troite sur la photo).  <strong>Figure&nbsp;1a).  <\/strong>La perte s\u00e9lective de fibres pontines transversales, associ\u00e9e \u00e0 la pr\u00e9servation des voies corticoc\u00e9r\u00e9belleuses, pr\u00e9sente un motif crois\u00e9 caract\u00e9ristique dans les s\u00e9quences transversales pond\u00e9r\u00e9es en T2 et Flair  <strong>(Fig. 2).  <\/strong>Celui-ci rappelle les petits pains anglais du Vendredi saint  <strong>(Fig. 2b),<\/strong>  c&#8217;est pourquoi la litt\u00e9rature parle de ce que l&#8217;on appelle le &#8220;Hot-Cross-Bun Sign&#8221;.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8929 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb2_np4_s21.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/625;height:341px; width:600px\" width=\"1100\" height=\"625\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\"><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Discussion : <\/strong>La paralysie visuelle supranucl\u00e9aire progressive (PSP) est une maladie tau avec une atrophie supra- et infratentorielle \u00e9tendue <strong>(figure 3).<\/strong> L&#8217;imagerie montre une atrophie caract\u00e9ristique du m\u00e9senc\u00e9phale d\u00e8s les premiers stades de la maladie. Sur les clich\u00e9s midsagittaux, le contour sup\u00e9rieur du tectum est concave (pointe de fl\u00e8che en  <strong>Fig. 3a)<\/strong>  ce qui rappelle l&#8217;image d&#8217;un colibri en vol. Sur les s\u00e9quences axiales, on observe une divergence des crura cerebri, qui ne sont elles-m\u00eames pas significativement atrophi\u00e9es, ce que l&#8217;on appelle le &#8220;Mickey Mouse Sign&#8221; <strong>(Fig. 3).<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"size-full wp-image-8930 lazyload\" alt=\"\" data-src=\"https:\/\/medizinonline.com\/wp-content\/uploads\/2017\/07\/abb3_np4_s21.jpg\" style=\"--smush-placeholder-width: 1100px; --smush-placeholder-aspect-ratio: 1100\/660;height:360px; width:600px\" width=\"1100\" height=\"660\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\"><\/p>\n<p>&nbsp;<\/p>\n<p>Alors que les signes susmentionn\u00e9s \u00e9taient initialement consid\u00e9r\u00e9s comme pathognomoniques de la MSA-C ou de la PSP, on pense aujourd&#8217;hui qu&#8217;il existe des chevauchements \u00e9vidents entre les sympt\u00f4mes. N\u00e9anmoins, l&#8217;imagerie m\u00e9dicale peut fournir une indication importante sur le diagnostic diff\u00e9rentiel.<\/p>\n<p>&nbsp;<\/p>\n<p><em>InFo NEUROLOGIE &amp; PSYCHIATRIE 2017 ; 15(4) : 20-21<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dans les syndromes parkinsoniens atypiques, l&#8217;imagerie montre souvent des motifs charact\u00e9ristiques qui permettent une attribution diganostique. Ces mod\u00e8les d&#8217;infestation portent souvent des noms \u00e9vocateurs.<\/p>\n","protected":false},"author":7,"featured_media":68650,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Petits pains du Vendredi saint et colibris","footnotes":""},"category":[11541,11345,11383,11549],"tags":[37691,12355,37688,37676,37681],"powerkit_post_featured":[],"class_list":["post-339558","post","type-post","status-publish","format-standard","has-post-thumbnail","category-cases-fr","category-contenu-des-partenaires","category-neurologie-fr","category-rx-fr","tag-ataxie-cerebelleuse","tag-maladie-de-parkinson","tag-paresie-visuelle-supranucleaire","tag-parkinson-plus-fr","tag-syndromes-parkinsoniens-atypiques","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-21 21:16:06","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"fr_FR","wpml_translations":{"it_IT":{"locale":"it_IT","id":339571,"slug":"modelli-di-manifestazione-tipici-delle-sindromi-di-parkinson-atipiche","post_title":"Modelli di manifestazione tipici delle sindromi di Parkinson atipiche","href":"https:\/\/medizinonline.com\/it\/modelli-di-manifestazione-tipici-delle-sindromi-di-parkinson-atipiche\/"},"pt_PT":{"locale":"pt_PT","id":339576,"slug":"padroes-tipicos-de-manifestacao-das-sindromes-atipicas-de-parkinson","post_title":"Padr\u00f5es t\u00edpicos de manifesta\u00e7\u00e3o das s\u00edndromes at\u00edpicas de Parkinson","href":"https:\/\/medizinonline.com\/pt-pt\/padroes-tipicos-de-manifestacao-das-sindromes-atipicas-de-parkinson\/"},"es_ES":{"locale":"es_ES","id":339580,"slug":"patrones-de-manifestacion-tipicos-de-los-sindromes-de-parkinson-atipicos","post_title":"Patrones de manifestaci\u00f3n t\u00edpicos de los s\u00edndromes de Parkinson at\u00edpicos","href":"https:\/\/medizinonline.com\/es\/patrones-de-manifestacion-tipicos-de-los-sindromes-de-parkinson-atipicos\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/339558","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/comments?post=339558"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/339558\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media\/68650"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media?parent=339558"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/category?post=339558"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/tags?post=339558"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/powerkit_post_featured?post=339558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}