Case report| Volume 27, ISSUE 1, P62-65, January 2005

Long-term follow-up of an adolescent who had bilateral striatal necrosis secondary to Mycoplasma pneumoniae infection


      We describe the long-term follow-up of a patient with bilateral striatal necrosis associated with Mycoplasma pneumoniae infection occurred in adolescence. In the literature there are no longitudinal studies of such a rare condition. Our patient, 4 years after the onset of an acute and reversible akinetic-rigid syndrome, showed a severe obsessive-compulsive disorder, cognitive decline, and a neuropsychological profile characterized by signs of deficient executive functioning. The clinical picture that emerged in our patient is suggestive of a frontosubcortical dementia which might be considered a major long-term sequela of the bilateral selective striatal necrosis and consequent dysfunction of frontostriatal connections.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Maia A.S.
        • Barbosa E.R.
        • Menezes P.R.
        • Filho E.C.
        Relationship between obsessive-compulsive disorders and diseases affecting primarily the basal ganglia.
        Rev Hosp Clı̀n Fac Med Sao Paulo. 1999; 54: 213-221
        • Zambrino C.A.
        • Zorzi G.
        • Lanzi G.
        • Uggetti C.
        • Egitto M.G.
        Bilateral striatal necrosis associated with Mycoplasma pneumoniae infection in an adolescent: clinical and neuroradiologic follow up.
        Mov Disord. 2000; 15: 1023-1026
        • Green C.
        • Riley D.E.
        Treatment of dystonia in striatal necrosis caused by Mycoplasma pneumoniae.
        Pediatr Neurol. 2002; 26: 318-320
        • Alexander G.E.
        • Crutcher M.D.
        • DeLong M.R.
        Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, prefrontal and limbic functions.
        Prog Brain Res. 1990; 85: 119-146
        • Baxter Jr., L.R.
        • Schwartz J.M.
        • Bergman K.S.
        • Szuba M.P.
        • Guze B.H.
        • Mazziotta J.C.
        • et al.
        Caudate glucose metabolic rate changes with both drug and behaviour therapy for obsessive-compulsive disorder.
        Arch Gen Psychiatry. 1992; 49: 681-689
        • Aronowitz B.R.
        • Hollander E.
        • Decaria C.
        Neuropsychology of obsessive-compulsive disorder: preliminary findings.
        Neuropsych Neuropsychol Behav Neurol. 1994; 7: 81-86
        • Christensen K.J.
        • Kim S.W.
        • Dysken M.W.
        • Hoover K.M.
        Neuropsychological performance in obsessive-compulsive disorder.
        Biol Psychiatry. 1992; 31: 4-18
        • Ring H.A.
        • Serra-Mestres J.
        Neuropsychiatry of the basal ganglia.
        J Neurol Neurosurg Psychiatry. 2002; 72: 12-21
        • Gross-Isseroff R.
        • Sasson Y.
        • Voet H.
        • Hendler T.
        • Luca-Haimovici K.
        • Kandel-Sussman H.
        • et al.
        Alternation learning in obsessive compulsive disorder.
        Biol Psychiatry. 1996; 39: 733-738