idiopathic parkinson disease. A magnetic resonance imaging study correlation with the clinical picture and the pattern of levodopa responsiveness

In the present study 20 patients with the clinical diagnosis of idiopathic parkinson disease are included. All patients were subjected to [1] full clinical examination and MRI study of the brain with a special focus on the mid-brain and the basal ganglia. Based on the duration of the parkinsonian symptomatology and the clinical response to levodopa treatment, patients were classified into two main groups. Group [A] is characterized by short duration of the parkinsonian symptomatology and a good sustained response to levodopa treatment, while group [B] was characterized by a longer duration of the parkinsonian symptomatology and a fluctuant response to levodopa treatment. MRI demonstrated important structural changes at the level of the substantia nigra and the red nucleus in both groups, while structural changes at the level of the basal ganglia [putaminal hypointensity on the T2 weighted images] were demonstrated only in group [B] patients. The significance of the MRI findings, their probable aetiology and pathogenesis, their value in explaining the pattern of clinical levodopa responsiveness and their implications in the management of parkinson disease will be discussed

acyclovir responsive herpes simplex encephalitis definition of its radiological features; correlation with the clinical picture and CSF analysis

In the present study 13 patient with the clinico- radiological diagnosis of herpes simplex encephalitis [HSE] are included. All patients were subjected to [1] full clinical examination [2] CSF analysis that included CSF chemistry [protein, glucose and chloride], cells, latex test for bacterial antigens, CSF culture of pyogenic bacteria and TB and PCR [polymerase chain reaction] for detection of both type I and type II herpes simplex virus [HSV] DNA [3] Both MRI and CT scan of the brain with and without contrast were done to all patients. CSF analysis showed moderate rise of proteins [average 860 mg/dl, normal values up to 450 mg/dl] with normal sugar and glucose and with a predominately lymphocytic pleocytosis in all patients. Latex test was negative for all patients. Both CSF bacterial and TB cultures were eventually negative. HSV type I DNA was detected in the CSF by the PCR test in all patients, type II HSV DNA was not detected in the CSF of any of the patients examined. Involvement of the temporal lobes unilaterally or bilaterally were the cardinal radiological feature demonstrated in all patients. Other areas of the brain, such as the orbital frontal region, the paraventricular region, the basal ganglia or the brain stem, are involved but less frequently. The significance of these findings for the early diagnosis of herpes encephalitis are discussed. Also the clinical course of the patients and their response to treatment will be presented and discussed