Arterial spin-labeling perfusion imaging of childhood encephalitis: correlation with seizure and clinical outcome

Wong, Alex Mun-Ching; Yeh, Chih‐Hua; Lin, Jainn-Jim; Liu, Ho Ling; Chou, I-Jun; Lin, Kuang-Lin; Wang, Huei-Shyong

doi:10.1007/s00234-018-2062-9

Cited by 14 publications

(12 citation statements)

References 40 publications

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“…Only one patient who manifested recurrent convulsive seizures followed by fever and headache was treated only with intravenous acyclovir, but she did not suffer from relapse for 2 years, hence, MOG antibody-positive UCCE may represent corticosteroid-responsive encephalitis and benign phenotype, but there is no agreement on the dose of the hormone. In addition, study indicated that MOG-Ab dynamics and their faster negativity would be an implication for good prognosis [14] , besides a research from childhood encephalitis showed that cases with brain hypoperfusion had poor neurological outcome and those with local hypertransfusion were more likely to have seizure [15] , which imply that cerebral perfusion may be associated with prognosis.…”

Section: Discussionmentioning

confidence: 97%

MOG-antibody Related Unilateral Cerebral Cortical Encephalitis With Refractory Cephalalgia: a Case Report

Ren

Lei

Zhu

et al. 2021

Preprint

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Background: Myelin oligodendrocyte glycoprotein (MOG) antibody positive utilateral cerebral cortical encephalitis (UCCE) comprises a new entity with heterogeneity which usually present as epilepsy. Cases with cephalalgia as the only clinical feature were rare reported. Here, We report a case with MOG antibody positive UCCE who only presented with refractory cephalalgia and had a good response to glucocorticoid. MOG antibody-related UCCE should be identified when patients present with refractory headache and it may represent benign cortical encephalitis.Case Presentation: The case of a 41-year-old woman with MOG antibody positive UCCE presented with refractory cephalalgia. Neurological examination is normal, and fundus examination suggested bilateral optic nerve head edema. Brain MRI discovered Flair hyperintense lesions in the sulci of right temporoparietal occipital cortex. MOG antibody was positive both in the serum and cerebrospinal fluid. When the patient was treated with intravenous methylprednisolone, her headache completely disappeared and brain MRI showed partly recovery. At the follow-up of 6 months after discharge, she had no relapse, serum MOG antibody was negative and the high signal intensity on Flair had completely disappeared.Conclusions: MOG antibody-positive UCCE with headache as the single clinical symptom may represent benign cortical encephalitis.

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Section: Discussionmentioning

confidence: 97%

MOG-antibody Related Unilateral Cerebral Cortical Encephalitis With Refractory Cephalalgia: a Case Report

Ren

Lei

Zhu

et al. 2021

Preprint

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“…Other physiologic neuroimaging techniques, such as perfusion imaging, may reflect more recent physiologic changes in the brain during the early stage of encephalitis. 15 Future studies might employ perfusion MRI to assess the cerebral blood flow of patients with rhombencephalitis and correlate these changes with the consciousness of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical outcome was graded by using the Glasgow Outcome Scale (GOS) at the end of the first week and 12th month after the onset of disease: 1, death; 2, neurovegetative state; 3, severe disability incompatible with independent living; 4, moderate disability but compatible with independence; and 5, full recovery. 12,14,15…”

Section: Mri Analysismentioning

confidence: 99%

Rhombencephalitis in Children: Diffusion Magnetic Resonance Imaging (MRI) Correlation With Clinical Outcomes

et al. 2020

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In children with rhombencephalitis, neuroimaging abnormalities have been infrequently correlated with clinical outcome. We investigated whether magnetic resonance (MR) neuroimaging studies could predict clinical outcomes and disturbance of consciousness in patients with rhombencephalitis. We retrospectively analyzed the MR studies of 19 pediatric patients with rhombencephalitis (median age: 4.2 years, range 0.5-17; sex: 32% male). Fluid-attenuated inversion recovery imaging and diffusion-weighted imaging findings were graded to create imaging scores according to the extent of imaging abnormality. Clinical outcomes in the first week and 12th month were graded by using Glasgow Outcome Scale scores (1-5) and dichotomized to unfavorable or favorable outcome. Correlations of the imaging scores with the clinical outcomes and with disturbance of consciousness were assessed by using multivariate logistic regression analysis. No significant correlation was found between fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .608, P = .132, respectively) and disturbance of consciousness. In the first week, the unfavorable outcome group (n = 11) had significantly higher diffusion-weighted imaging score than did the favorable outcome group (n = 8) (Mann-Whitney U test, P = .005). Multivariate logistic regression analysis showed that the diffusion-weighted imaging score (odds ratio, 18.182; 95% confidence interval: 1.36, 243.01; P = .028) was significantly associated with unfavorable outcome. In the 12th month, the fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .994, P = .997, respectively) were not significantly associated with unfavorable outcome. Patients with rhombencephalitis who have a higher diffusion-weighted imaging score are more likely to have an unfavorable 1-week clinical outcome.

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“…However, in mild encephalopathy with a reversible splenial lesion (MERS), the T2-hyperintensity and restricted diffusion of the splenial leison resolve completely or near completely on follow-up imaging within days to weeks and affected children usually have good outcomes [ 81 ]. Perfusion imaging (ASL imaging) may show elevated cerebral blood flow, suggestive of seizure activity [ 82 ]. In addition, diffuse hypoperfusion of the brain indicates poor clinical outcomes.…”

Section: Mr Neuroimagingmentioning

confidence: 99%

Spectrum of neuroimaging mimics in children with COVID-19 infection

Wong

Toh

2022

Biomedical Journal

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Arterial spin-labeling perfusion imaging of childhood encephalitis: correlation with seizure and clinical outcome

Abstract: In childhood encephalitis, patients with extreme global hypoperfusion had poor neurological outcome and those with focal hypoperfusion were more likely to have seizure.

Cited by 14 publications

References 40 publications

MOG-antibody Related Unilateral Cerebral Cortical Encephalitis With Refractory Cephalalgia: a Case Report

MOG-antibody Related Unilateral Cerebral Cortical Encephalitis With Refractory Cephalalgia: a Case Report

Rhombencephalitis in Children: Diffusion Magnetic Resonance Imaging (MRI) Correlation With Clinical Outcomes

Spectrum of neuroimaging mimics in children with COVID-19 infection

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