Assuntos
Dano Encefálico Crônico/fisiopatologia , Mapeamento Encefálico/instrumentação , Eletroencefalografia/instrumentação , Epilepsias Parciais/fisiopatologia , Processamento de Imagem Assistida por Computador/instrumentação , Dano Encefálico Crônico/diagnóstico , Córtex Cerebral/fisiopatologia , Criança , Pré-Escolar , Diagnóstico por Imagem/instrumentação , Dominância Cerebral/fisiologia , Epilepsias Parciais/diagnóstico , Potenciais Evocados/fisiologia , Feminino , Humanos , MasculinoRESUMO
We describe here chronological single photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) of a patient with subacute sclerosing panencephalitis (SSPE) from the early clinical stages. The case, an 8-year-old Japanese girl, was in clinical stage I of the disease on admission. A SPECT study with 99mTc-hexamethylprophyleamine oxime (99mTc-HM PAO) and 123I-IMP revealed hypoperfusion of cerebral blood flow in the bilateral occipital areas and a part of the cerebellum. Initially, no abnormal findings were observed on CT and MRI. Subsequently, however, MRI indicated abnormal signal intensity dominantly in the area of the occipital white matter where hypoperfusion of cerebral blood flow was found by the initial SPECT studies. This abnormal cerebral hypoperfusion appeared to improve after treatment with oral inosiplex and intrathecal interferon-alpha over 6 months of the clinical course. The abnormal signal intensity on the MRI also decreased, but simultaneous cranial CT demonstrated diffuse cortical atrophy and slight ventricular dilatation.
Assuntos
Panencefalite Esclerosante Subaguda/diagnóstico por imagem , Anfetaminas , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Criança , Feminino , Humanos , Radioisótopos do Iodo , Iofetamina , Imageamento por Ressonância Magnética , Compostos de Organotecnécio , Oximas , Panencefalite Esclerosante Subaguda/patologia , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
We report here a case of a patient with subacute sclerosing panencephalitis (SSPE) and we have analyzed periodic events using dipole tracing methods to clarify the origin of periodic synchronous discharges and myoclonus. Both source generators were located in the subcortical part of the cerebrum, an area adjacent to the thalamus. Although the pathophysiology of periodic events in SSPE has been controversial, dipole tracing methods may contribute to clarify the origin of periodic events in SSPE.
