Multifocal inflammatory leukoencephalopathy: use of thallium-201 SPECT and proton MRS

In a patient receiving 5-fluorouracil and levamisole, neurologic deficits suggest the cerebral demyelinating syndrome as a differential diagnosis. The authors report a patient diagnosed as multifocal inflammatory leukoencephalopathy for which thallium-201 (201Tl) single photon emission computed tomo...

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Bibliographic Details
Published in:Journal of Korean medical science 2003-08, Vol.18 (4), p.621-624
Main Authors: Hwang, Yang Ha, Suh, Chung Kyu, Park, Sung Pa
Format: Article
Language:English
Subjects:
Adjuvants, Immunologic - adverse effects
Adjuvants, Immunologic - therapeutic use
Antimetabolites, Antineoplastic - adverse effects
Antimetabolites, Antineoplastic - therapeutic use
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Axons - pathology
Biopsy
Brain - pathology
Brain Neoplasms - secondary
Choline - metabolism
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - pathology
Diagnosis, Differential
Fluorouracil - adverse effects
Fluorouracil - therapeutic use
Humans
Lactic Acid - metabolism
Leukoencephalopathy, Progressive Multifocal - diagnosis
Leukoencephalopathy, Progressive Multifocal - etiology
Levamisole - adverse effects
Levamisole - therapeutic use
Magnetic Resonance Spectroscopy - methods
Male
Middle Aged
Neoplasm Metastasis
Thallium Radioisotopes
Tomography, Emission-Computed, Single-Photon - methods
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Description
Summary:In a patient receiving 5-fluorouracil and levamisole, neurologic deficits suggest the cerebral demyelinating syndrome as a differential diagnosis. The authors report a patient diagnosed as multifocal inflammatory leukoencephalopathy for which thallium-201 (201Tl) single photon emission computed tomography (SPECT) and proton magnetic resonance spectroscopy (MRS) were employed as noninvasive diagnostic tools. 201Tl SPECT study was negative and proton MRS showed an increase of choline and lactate and well preserved N-acetylaspartate. These findings support histopathologic findings of multifocal inflammatory leukoencephalopathy revealing demyelination with relative axonal sparing in the patient.
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2003.18.4.621