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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2003-4-9
pubmed:abstractText
Rasmussen's encephalitis (RE) is a rare, progressive, chronic encephalitis characterised by drug-resistant epilepsy, progressive hemiparesis and mental impairment. It typically involves only one cerebral hemisphere, which becomes atrophic. We present neuroradiological findings in 13 children with RE. MRI was performed in all patients, fluorodeoxyglucose positron-emission tomography (PET) in three, Tc-99m hexamethylpropylenamine oxime single-photon emission computed tomography (SPECT) in two and proton MR spectroscopy ((1)HMRS) in two. MRI showed progression of the hemisphere atrophy, always prevalent in the region primarily involved (13 patients), spread of the abnormal signal in white matter (11) and cortex (10) and progression of atrophy of the head of the caudate nucleus (nine). Associated secondary changes were: atrophy of the contralateral cerebellar hemisphere (in four patients), the ipsilateral hippocampus (in five) and the brain stem (in five). The earliest CT and MRI abnormalities, seen between 1 day and 4 months after the first seizure (in 12 patients examined, nine of whom had MRI) in one cerebral hemisphere included: high signal on T2-weighted images in the cortex (seven patients) and white matter (nine), cortical atrophy usually involving the frontoinsular region, with mild or severe enlargement of the lateral ventricle (eight) and moderate atrophy of the head of the caudate nucleus (seven). Cortical swelling in the early stage of the disease was recognisable only in two patients. PET revealed hypometabolism, SPECT decreased perfusion, and (1)HMRS reduction of N-acetylaspartate in the affected hemisphere. PET and SPECT were usually performed in the late stages and did not provide specific findings. MRI thus demonstrates the progression of RE and may suggest the diagnosis in the early stages, often before the appearance of neurological deficits. Early diagnosis of RE may be crucial for selecting patients for aggressive medical therapy or major surgical interventions such as hemispherectomy.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0028-3940
pubmed:author
pubmed:issnType
Print
pubmed:volume
45
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
171-83
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12684722-Atrophy, pubmed-meshheading:12684722-Brain, pubmed-meshheading:12684722-Child, pubmed-meshheading:12684722-Child, Preschool, pubmed-meshheading:12684722-Diagnosis, Differential, pubmed-meshheading:12684722-Disease Progression, pubmed-meshheading:12684722-Encephalitis, pubmed-meshheading:12684722-Female, pubmed-meshheading:12684722-Fluorodeoxyglucose F18, pubmed-meshheading:12684722-Humans, pubmed-meshheading:12684722-Infant, pubmed-meshheading:12684722-Magnetic Resonance Imaging, pubmed-meshheading:12684722-Magnetic Resonance Spectroscopy, pubmed-meshheading:12684722-Male, pubmed-meshheading:12684722-Protons, pubmed-meshheading:12684722-Radiopharmaceuticals, pubmed-meshheading:12684722-Retrospective Studies, pubmed-meshheading:12684722-Technetium Tc 99m Exametazime, pubmed-meshheading:12684722-Tomography, Emission-Computed, pubmed-meshheading:12684722-Tomography, Emission-Computed, Single-Photon
pubmed:year
2003
pubmed:articleTitle
Diagnostic imaging in 13 cases of Rasmussen's encephalitis: can early MRI suggest the diagnosis?
pubmed:affiliation
Department of Neuroradiology, Istituto Nazionale Neurologico C Besta, Via Celoria 11, 20133 Milano, Italy. l.chiapparini@doctor.com
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Multicenter Study