Short report
Serial perfusion brain tomographic scans detect reversible focal
ischaemia in Rasmussen's encephalitis
Sobhan Vinjamuria, J P Leachb, I K Hartc
a Nuclear Medicine
Department, Royal Liverpool University Hospital, Liverpool, UK, b Walton Centre for Neurology
and Neurosurgery, Liverpool, UK Department of
Neurology, c University
Department of Neurological Sciences
Correspondence to: Dr S Vinjamuri, Consultant in Nuclear Medicine, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK
Submitted 23 April
1999;
Accepted 23 June 1999
A 39-year-old man with advanced adult-onset Rasmussen's
encephalitis was treated with prednisolone and long-term, high-dose, human intravenous immunoglobulin. A pretreatment, semiquantitative interictal brain perfusion single photon emission computed tomography (SPECT) scan using 99Tcm HMPAO (hexamethylene
propylene amine oxime) showed hypoperfusion in the clinically affected
right frontal, parietal and temporal lobes and contralateral perfusion
defects. A second scan 8 months later revealed significant improvements
(more than two standard deviations) in perfusion of the right frontal
and temporal lobes despite serial magnetic resonance imaging evidence
of permanent brain damage. This was associated with useful recovery of
the patient's physical and cognitive function. We conclude that serial perfusion brain SPECT scanning is a useful method to demonstrate improvement in patients with Rasmussen's encephalitis in response to therapy.
Keywords: brain; SPECT scanning; Rasmussen's encephalitis
© 2000 by The Fellowship of Postgraduate Medicine
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