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
Department of Neurology, CSM Medical University (erstwhile, King George«SQ»s Medical University), Lucknow - 226 003
|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
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. , 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%.  Patients with Parkinson's disease, multisystem atrophy, and corticobasal degeneration have no midbrain atrophy and therefore do not show this sign.
|1||Kato N, Arai K, Hattori T. Study of the rostral midbrain atrophy in progressive supranuclear palsy. J Neurol Sci 2003;210:57-60.|
|2||Grφschel K, Kastrup A, Litvan I, Schulz JB. Penguins and hummingbirds: Midbrain atrophy in progressive supranuclear palsy. Neurology 2006; 66:949-50.|