Annals of Indian Academy of Neurology
IMAGES IN NEUROLOGY
Year
: 2009  |  Volume : 12  |  Issue : 2  |  Page : 133-

'Hummingbird' sign in progressive supranuclear palsy


Rakesh Shukla, Manish Sinha, Rajesh Kumar, Dilip Singh 
 Department of Neurology, CSM Medical University (erstwhile King George's Medical University), Lucknow - 226 003, India

Correspondence Address:
Rakesh Shukla
Department of Neurology, CSM Medical University (erstwhile, King George«SQ»s Medical University), Lucknow - 226 003
India




How to cite this article:
Shukla R, Sinha M, Kumar R, Singh D. 'Hummingbird' sign in progressive supranuclear palsy.Ann Indian Acad Neurol 2009;12:133-133


How to cite this URL:
Shukla R, Sinha M, Kumar R, Singh D. 'Hummingbird' sign in progressive supranuclear palsy. Ann Indian Acad Neurol [serial online] 2009 [cited 2021 Oct 21 ];12:133-133
Available from: https://www.annalsofian.org/text.asp?2009/12/2/133/53087


Full Text

Presence of the 'hummingbird' sign in brain MRI is an interesting radiological sign in the patients with progressive supranuclear palsy (PSP). In this article we report a patient of PSP who demonstrated the 'hummingbird' sign.

A 66-year-old male presented with slowness of activities and falls while walking; his symptoms had an insidious onset and had been gradually progressive over the last 3 years. He gave no history of tremulousness, forgetfulness, hallucinations, postural dizziness, or urinary incontinence. There was no history of a similar illness in his family.

On examination, supranuclear horizontal and vertical gaze palsies, axial rigidity, bradykinesia, and generalized hyperreflexia were present. The patient was diagnosed as probable PSP. Midsagittal T1-weighted MRI of the brain revealed atrophy of the midbrain tegmentum, with a relatively preserved pons; this gave an appearance resembling the head and body, respectively, of a hummingbird [Figure 1]. This is known as the 'hummingbird' sign. [1],[2] Demonstration of the hummingbird sign on MRI is thought to be useful for establishing the diagnosis of PSP; it is reported to have a sensitivity of nearly 100%. [1] Patients with Parkinson's disease, multisystem atrophy, and corticobasal degeneration have no midbrain atrophy and therefore do not show this sign.

References

1Kato N, Arai K, Hattori T. Study of the rostral midbrain atrophy in progressive supranuclear palsy. J Neurol Sci 2003;210:57-60.
2Grφschel K, Kastrup A, Litvan I, Schulz JB. Penguins and hummingbirds: Midbrain atrophy in progressive supranuclear palsy. Neurology 2006; 66:949-50.