Computed tomography of the brain in subacute sclerosing panencephalitis

Abstract

Twenty-four computed tomographic scans of 12 patients with confirmed subacute sclerosing panencephalitis were studied using standardized techniques of radiological assessment. Abnormalities encountered were of four types--(1) lateral ventricular dilatation, (2) cerebral cortical atrophy and sylvian fissure widening, (3) low parenchymal attenuation, and (4) brainstem atrophy and cerebellar atrophy--and of varying degrees. The abnormalities correlated best with the stage and duration of disease, but not necessarily well with the patient's mental state. The fewest radiological abnormalities were encountered in the acute or early stages, whereas more signs of parenchymal disturbances in the form of low attenuations emerged during intermediate periods. Chronic periods were accompanied by atrophic changes in the form of cortical atrophy, ventricular dilatation, and brainstem cerebellar atrophy.

Subacute Sclerosing Panencephalitis: Imaging and Clinical Correlation

“…Despite periods of considerable clinical improvement, the imaging studies revealed progressive parenchymal loss and diffuse demyelination. Large areas of acute white matter destruction have been reported [13,15]; these may enhance initially but later they become nonenhancing and presumably correlate with gliosis. Large areas of acute white matter destruction have been reported [13,15]; these may enhance initially but later they become nonenhancing and presumably correlate with gliosis.…”

Regional cerebral metabolic rate for glucose and cerebrospinal fluid monoamine metabolites in subacute sclerosing panencephalitis.

“…Cerebrospinal fluid specimens used as the control values were withdrown from 8 agematched children without neurological disease. Krawiecki et al (1984) have reported that abnormalities encountered on conventional x-ray CT were of four types ; (1) lateral ventricular dilatation, (2) cerebral cortical atrophy, (3) low parenchymal attenuation, and (4) brain stem atrophy and cerebellar atrophy. They also pointed out that the abnormalities correlated well with the duration of disease, but not necessarily well with the patient's intelligence.…”

“…Conventional x-ray CT scans of affected subjects are either normal or slightly atrophic in early stages. Widened ventricles, lateral ventricular dilatation, sylvian fissure widening and progressive brain atrophy have been demonstrated with the progression of the illness (Duda et al 1980; Krawiecki et al 1984). However, very few studies have been reported on cerebral function in SSPE.…”

Twenty-Year Follow-Up of a Patient with Subacute Sclerosing Panencephalitis

“…Brismar et al [6] evaluated MRI fi ndings in SSPE in stages 1-4 by grading cerebral atrophy and white matter changes, but found less correlation between the severity of the MRI changes and the clinical fi ndings. On the other hand, Krawiecki et al [4] graded CT fi ndings in SSPE based on lateral ventricle dilatation, cortical atrophy, low parenchymal attenuation, and brainstem and cerebellar atrophy, and found a signifi cant correlation with the duration of the disease. In our patient, cortical and subcortical atrophy progressed gradually after rapid infl ammatory changes in CT fi ndings during the early period, and MRI taken 9 years after onset showed severe loss of brain tissue and marked atrophy in the brain stem, cerebellum and spinal cord.…”

“…CSF reverse transcriptase polymerase chain reaction for measles RNA was negative on repeated examination in the later stage in our patient, but this [8] . Progression of the symptoms and radiological fi ndings in the far advanced stage have rarely been reported [4][5][6] . Brismar et al [6] evaluated MRI fi ndings in SSPE in stages 1-4 by grading cerebral atrophy and white matter changes, but found less correlation between the severity of the MRI changes and the clinical fi ndings.…”