Ziyeh Sargon, Thiel Thorsten, Spreer Joachim, Klisch Joachim, Schumacher Martin
Section of Neuroradiology, Department of Neurosurgery, and Section of Medical Physics, Department of Diagnostic Radiology, University Hospital, Freiburg, Germany.
Epilepsia. 2002 Sep;43(9):1101-5. doi: 10.1046/j.1528-1157.2002.42201.x.
The anticonvulsant agent valproate (VPA) may cause hyperammonemic encephalopathy. Magnetic resonance imaging (MRI) and proton MR spectroscopic (MRS) findings in a patient with VPA-induced hyperammonemic encephalopathy are described. MRI showed a metabolic-toxic lesion pattern with bilateral T2-hyperintense lesions in the cerebellar white matter and in the globus pallidus. MR spectroscopic findings were indistinguishable from hepatic encephalopathy with severe depletion of myoinositol and choline and with glutamine excess. N-Acetylaspartate levels were moderately decreased. Quantitative MRS gave detailed insight into alterations of brain metabolism in VPA-induced encephalopathy.
抗惊厥药物丙戊酸盐（VPA）可能会导致高氨血症性脑病。本文描述了一名VPA诱导的高氨血症性脑病患者的磁共振成像（MRI）和质子磁共振波谱（MRS）检查结果。MRI显示出代谢性毒性病变模式，小脑白质和苍白球出现双侧T2高信号病变。MRS检查结果与肝性脑病难以区分，肌醇和胆碱严重缺乏，谷氨酰胺过量。N-乙酰天门冬氨酸水平中度降低。定量MRS详细揭示了VPA诱导的脑病中脑代谢的变化。
