Annals of Indian Academy of Neurology
: 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

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
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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.


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