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Updated: Feb 14, 2026
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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
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Reversible Parkinsonism With Recovery of 123 I-Ioflupane DAT‑SPECT After Treating Rheumatoid Meningitis.
Taro Bannai1, Koshiro Yoshii, Minako Yamada
1Department of Neurology, Tokyo Teishin Hospital, Tokyo, Japan.
Clinical Nuclear Medicine
|February 13, 2026
Summary
Rheumatoid meningitis can cause reversible parkinsonism and brain changes. Immunotherapy effectively treated these symptoms, normalizing brain imaging and restoring function.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Rheumatoid meningitis is a rare complication of rheumatoid arthritis.
- Parkinsonism can be a presenting symptom of central nervous system involvement in autoimmune diseases.
Purpose of the Study:
- To report a case of reversible parkinsonism secondary to rheumatoid meningitis.
- To investigate the utility of 123I-ioflupane DAT-SPECT in assessing dopaminergic dysfunction in this condition.
Main Methods:
- Case report of a 42-year-old male with fever, encephalopathy, seizures, and parkinsonism.
- Neuroimaging including MRI and 123I-ioflupane DAT-SPECT.
- Cerebrospinal fluid (CSF) analysis.
- Treatment with high-dose intravenous methylprednisolone and subsequent taper.
Main Results:
- MRI revealed pachy/leptomeningeal enhancement and sulcal FLAIR hyperintensity.
- CSF showed lymphocytic pleocytosis and elevated protein with negative infectious studies.
- Baseline 123I-ioflupane DAT-SPECT demonstrated reduced striatal uptake.
- Symptoms resolved rapidly following immunotherapy, with normalization of DAT-SPECT findings on follow-up.
- Reductions in intrathecal anti-CCP index and CSF IL-6 correlated with clinical improvement.
Conclusions:
- Reversible parkinsonism can occur in the context of rheumatoid meningitis.
- Immunotherapy is an effective treatment, leading to clinical and radiological improvement.
- 123I-ioflupane DAT-SPECT can track reversible presynaptic dopaminergic dysfunction in autoimmune meningitis.
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