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Title: Longitudinal study of MRS metabolites in Rasmussen encephalitis.
Austin Authors: Wellard, R M;Briellmann, Regula S;Wilson, J C;Kalnins, Renate M;Anderson, D P;Federico, P;Fabinyi, Gavin C ;Scheffer, Ingrid E ;Harvey, A Simon;Jackson, Graeme D 
Affiliation: Director, Brain Research Center, Austin Health, Neurosciences Building, Banksia St, Heidelberg West 3081, Australia
Issue Date: 6-Apr-2004
Publication information: Brain : A Journal of Neurology 2004; 127(Pt 6): 1302-12
Abstract: This study analyses the evolution of metabolite changes in an 8-year-old boy with focal Rasmussen encephalitis. Five MRI examinations, including magnetic resonance spectroscopy (MRS) were performed over 9 months. Following complex partial status, T2-weighted imaging showed transient dramatic signal increase in the left superior temporal gyrus and mesial temporal structures. Subsequent scans showed resolution of the swelling and signal normalization, with development of slight focal atrophy. MRS after status showed a reduction in N-acetylaspartate, total creatine and trimethylamines. Subsequent scans showed complete resolution of these metabolite abnormalities, followed later by development of further abnormal metabolite values. Lactate and glutamine/glutamate were elevated after status. After surgery, ex vivo high-field (1)H and (31)P MRS confirmed metabolite abnormalities (elevated choline and decreased aspartate, N-acetylaspartate, [(1)H]glutamate together with altered [(31)P]phospholipid ratios. These findings suggested active disease process in the anterior region of the excised superior temporal gyrus. We conclude that Rasmussen encephalitis is a combination of progressive encephalitic damage and fluctuating seizure effects, in which neuronal injury and recovery can occur. MRS measurements at a single time point should consider the fluctuating metabolite profile related to seizure activity.
DOI: 10.1093/brain/awh157
Type: Journal Article
Subjects: Child
Epilepsy, Complex
Longitudinal Studies
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Temporal Lobe.metabolism
Appears in Collections:Journal articles

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