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Case report: Cervical spinal cord signal changes in a case of adult-onset subacute sclerosing panenchephalitis.

Sharma S, Kumar S - Indian J Radiol Imaging (2010)

Bottom Line: In this article, we report a case of subacute sclerosing panencephalitis (SSPE) in which there were central cervical cord signal changes on MRI.The spinal cord is uncommonly involved in SSPE.However, demonstration of spinal cord signal change in a patient of SSPE has significant implications for the differential diagnosis and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroradiology, AIIMS, Ansari Nagar, New Delhi - 110 029, India.

ABSTRACT
In this article, we report a case of subacute sclerosing panencephalitis (SSPE) in which there were central cervical cord signal changes on MRI. The spinal cord is uncommonly involved in SSPE. However, demonstration of spinal cord signal change in a patient of SSPE has significant implications for the differential diagnosis and management.

No MeSH data available.


Related in: MedlinePlus

Sagittal T2W MRI image of the cervical spine shows central hyperintensity (arrow) extending from C3 to C7
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Figure 0001: Sagittal T2W MRI image of the cervical spine shows central hyperintensity (arrow) extending from C3 to C7

Mentions: A 25-year-old woman presented with a history of sudden visual loss in her right eye 5 years ago, intermittent jerking of the body for 10 months, insidious onset of weakness of the left upper limb 10 months back, weakness of the left lower limb 8 months back, sudden diminution of vision in the left eye 2 months back, and urinary incontinence for 2 weeks. On examination, she was conscious, not oriented to place or time, and was able to identify only her husband. Her speech was interrupted due to myoclonic jerks, which involved the whole body (the left side more than the right), with slow relaxation every 8–10 s. Power was 4/5 on the left side, deep tendon reflexes on both sides were 3+, and the plantars were downgoing. An MRI study of the spine [Figures 1 and 2] and brain [Figures 3 and 4] was performed. MRI of the brain showed large confluent hyperintensities involving the temporal, parietal, and occipital lobe white matter and the right thalamus on T2W [Figure 3] and FLAIR [Figure 4] images. The signal abnormality was asymmetric – being more widespread on the right side – and extended from the subcortical white matter to the periventricular white matter. No definite evidence of mass effect or volume loss was evident. MRI of the spine showed a central cervical cord hyperintensity extending from C3 to C7 [Figures 1 and 2]. Although brain MRI was suggestive of the diagnosis of SSPE, the presence of the cervical cord signal led to a battery of investigations for other neurologic diseases that can cause signal changes in both the brain and the cervical spine on MRI. Further investigations included EEG (which revealed periodic discharges every 3–5 s) and serum and CSF anti-measles IgG antibody levels (which gave test values of 2.734 and 1.396 as against control values of 0.524 and 0.258, respectively). Diagnosis of SSPE was made after extensive exclusion of other diseases and on the basis of the clinical presentation, EEG, anti-measles antibody titers, and characteristic MRI brain findings.


Case report: Cervical spinal cord signal changes in a case of adult-onset subacute sclerosing panenchephalitis.

Sharma S, Kumar S - Indian J Radiol Imaging (2010)

Sagittal T2W MRI image of the cervical spine shows central hyperintensity (arrow) extending from C3 to C7
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2963762&req=5

Figure 0001: Sagittal T2W MRI image of the cervical spine shows central hyperintensity (arrow) extending from C3 to C7
Mentions: A 25-year-old woman presented with a history of sudden visual loss in her right eye 5 years ago, intermittent jerking of the body for 10 months, insidious onset of weakness of the left upper limb 10 months back, weakness of the left lower limb 8 months back, sudden diminution of vision in the left eye 2 months back, and urinary incontinence for 2 weeks. On examination, she was conscious, not oriented to place or time, and was able to identify only her husband. Her speech was interrupted due to myoclonic jerks, which involved the whole body (the left side more than the right), with slow relaxation every 8–10 s. Power was 4/5 on the left side, deep tendon reflexes on both sides were 3+, and the plantars were downgoing. An MRI study of the spine [Figures 1 and 2] and brain [Figures 3 and 4] was performed. MRI of the brain showed large confluent hyperintensities involving the temporal, parietal, and occipital lobe white matter and the right thalamus on T2W [Figure 3] and FLAIR [Figure 4] images. The signal abnormality was asymmetric – being more widespread on the right side – and extended from the subcortical white matter to the periventricular white matter. No definite evidence of mass effect or volume loss was evident. MRI of the spine showed a central cervical cord hyperintensity extending from C3 to C7 [Figures 1 and 2]. Although brain MRI was suggestive of the diagnosis of SSPE, the presence of the cervical cord signal led to a battery of investigations for other neurologic diseases that can cause signal changes in both the brain and the cervical spine on MRI. Further investigations included EEG (which revealed periodic discharges every 3–5 s) and serum and CSF anti-measles IgG antibody levels (which gave test values of 2.734 and 1.396 as against control values of 0.524 and 0.258, respectively). Diagnosis of SSPE was made after extensive exclusion of other diseases and on the basis of the clinical presentation, EEG, anti-measles antibody titers, and characteristic MRI brain findings.

Bottom Line: In this article, we report a case of subacute sclerosing panencephalitis (SSPE) in which there were central cervical cord signal changes on MRI.The spinal cord is uncommonly involved in SSPE.However, demonstration of spinal cord signal change in a patient of SSPE has significant implications for the differential diagnosis and management.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroradiology, AIIMS, Ansari Nagar, New Delhi - 110 029, India.

ABSTRACT
In this article, we report a case of subacute sclerosing panencephalitis (SSPE) in which there were central cervical cord signal changes on MRI. The spinal cord is uncommonly involved in SSPE. However, demonstration of spinal cord signal change in a patient of SSPE has significant implications for the differential diagnosis and management.

No MeSH data available.


Related in: MedlinePlus