Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea.
Department of Nuclear Medicine, School of Medicine, Chosun University, Gwangju, South Korea.
Am J Case Rep. 2020 Jul 9;21:e923406. doi: 10.12659/AJCR.923406.
BACKGROUND Osmotic demyelination syndrome (ODS) is an uncommon neurological disorder. Until the mid-1980s, the mortality rate was 90-100%, but more than half of patients now have a good prognosis. Early suspicion of ODS is important. However, radiologic findings of ODS are variable and scintigraphy findings have not been reported. CASE REPORT A 38-year-old man with alcohol abuse history was admitted due to electrolyte imbalance. On the 10th day of his hospital stay, he had a generalized tonic-clonic seizure. Brain perfusion SPECT showed asymmetrically hyperperfused and hypoperfused lesions. Brain MRI revealed diffuse T2 hyperintensity with mild diffusion restriction in the pons and hyperperfused lesions on brain SPECT. He was treated based on the diagnosis of hyponatremia and osmotic demyelination. After treatment, the asymmetric hyperperfusion was decreased. MRI showed that the cortical hyperintensity had resolved, with encephalomalacic change shown in the pons. CONCLUSIONS To the best of our knowledge, this is the first report showing changes in brain perfusion SPECT and MRI in an ODS patient with a seizure. This case report may be helpful to neurologists, radiologists, and nuclear physicians.
渗透性脱髓鞘综合征（ODS）是一种罕见的神经系统疾病。直到 20 世纪 80 年代中期，死亡率为 90-100%，但现在超过一半的患者预后良好。早期怀疑 ODS 很重要。然而，ODS 的放射学表现是多样的，并且尚未报道闪烁扫描的结果。
一名 38 岁的男性，有酒精滥用史，因电解质失衡入院。在住院的第 10 天，他发生了全身性强直阵挛性发作。脑灌注 SPECT 显示不对称性高灌注和低灌注病变。脑 MRI 显示脑桥弥漫性 T2 高信号，轻度弥散受限，脑 SPECT 显示高灌注病变。根据低钠血症和渗透性脱髓鞘的诊断进行了治疗。治疗后，不对称性高灌注减少。MRI 显示皮质高信号已消退，脑桥出现脑软化改变。
据我们所知，这是首例报告显示伴有癫痫发作的 ODS 患者的脑灌注 SPECT 和 MRI 变化。本病例报告可能对神经科医生、放射科医生和核医学医生有帮助。
