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

Abstract

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.

• Authors: Yang Ha Hwang, Chung Kyu Suh, Sung Pa Park
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 18 Issue 4 Pg. 621-4 (Aug 2003) ISSN: 1011-8934 [Print] Korea (South)
• PMID: 12923348 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adjuvants, Immunologic
• Antimetabolites, Antineoplastic
• Thallium Radioisotopes
• Levamisole
• Aspartic Acid
• Lactic Acid
• N-acetylaspartate
• Choline
• Fluorouracil

Topics

• Adjuvants, Immunologic (adverse effects, therapeutic use)
• Antimetabolites, Antineoplastic (adverse effects, therapeutic use)
• Aspartic Acid (analogs & derivatives, metabolism)
• Axons (pathology)
• Biopsy
• Brain (pathology)
• Brain Neoplasms (secondary)
• Choline (metabolism)
• Colorectal Neoplasms (drug therapy, pathology)
• Diagnosis, Differential
• Fluorouracil (adverse effects, therapeutic use)
• Humans
• Lactic Acid (metabolism)
• Leukoencephalopathy, Progressive Multifocal (diagnosis, etiology)
• Levamisole (adverse effects, therapeutic use)
• Magnetic Resonance Spectroscopy (methods)
• Male
• Middle Aged
• Neoplasm Metastasis
• Thallium Radioisotopes
• Tomography, Emission-Computed, Single-Photon (methods)