In vivo cerebral proton MRS in a case of subacute sclerosing panencephalitis

Abstract

(A and C) Location of the 2 spectroscopic volumes of interest (VOI = 2×2×2 cm) displayed on T2 weighted MRI showing asymmetric frontal white matter hypersignals. (B) Short echo STEAM spectra obtained from the frontal brain lesion and (D) from the parieto-occipital brain lesion in the patient with SSPE. Ins=myoinositol (3.54 ppm), Tau=taurine/scylloinositol (3.33 ppm), Cho=choline containing compounds (3.20 ppm), Cr-PCr=creatine/phosphocreatine (3.04 ppm), Glx=glutamate-glutamine (2.10–2.45 ppm), NAA=N-acetylaspartate (2.02 ppm), Lip=lipids and/or proteins (between 1.5 and 0.2 ppm). Subacute sclerosing panencephalitis (SSPE) is a rare encephalopathy caused by persistent defective measles virus in the CNS. Brain lesions may involve all regions of the CNS. The pathophysiological events associated with the disease are characterised by a perivascular infiltration by monocytes and astrocytic proliferation, neuronal degeneration, and demyelination.1 The exploration of SSPE by brain proton magnetic resonance spectroscopy (MRS) might be of interest to evaluate the extent of the metabolic lesions across the brain. We report here cerebral MRS findings in a 17 year old boy with SSPE. The first symptoms—difficulties at school—appeared at the age of 16. Six months later, abnormal movements occurred. The symptoms progressed rapidly over the next 2 months with myoclonic …