Higuchi T, Inaba Y, Hata Y, Seki C, Ichikawa M
Department of Pediatrics, Shinshu University School of Medicine, Nagano.
No To Hattatsu. 1998 Sep;30(5):403-9.
Magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT) and magnetic resonance spectroscopy (MRS) were successively recorded in a 3-year-old girl with the acute hemiplegia syndrome. She was admitted to our hospital with complaints of fever, loss of consciousness and right side dominant clonic convulsions evolving into status epilepticus, and then recovered with sequelae of aphasia and right hemiparesis. Electroencephalography showed a generalized slow rhythm at the onset, and very low activities on the left hemisphere in the follow-up records. Brain CT and MRI revealed edema of the left hemisphere initially, followed by left side dominant brain atrophy. No cerebral vascular lesion was detected by magnetic resonance angiography. N-Isopropyl-[123I]-iodoamphetamine SPECT showed marked hypoperfusion of the left hemisphere accompanied by crossed cerebellar diaschisis. MRS at the initial stage detected decreased N-acetyl-aspartic acid and increased lactic acid signals in the bilateral hemisphere, which subsequently normalized only on the right side. These findings suggested brain damage and neural cell death in the left cerebral hemisphere, caused by acute encephalopathy. SPECT and MRS are useful new techniques to study the pathophysiology of the acute hemiplegia syndrome.
对一名患有急性偏瘫综合征的3岁女孩先后进行了磁共振成像（MRI）、单光子发射计算机断层扫描（SPECT）和磁共振波谱分析（MRS）。她因发热、意识丧失和以右侧为主的阵挛性惊厥发展为癫痫持续状态入院，随后康复，但遗留失语症和右侧偏瘫后遗症。脑电图显示发病初期为广泛性慢节律，随访记录显示左半球活动极低。脑部CT和MRI最初显示左半球水肿，随后出现以左侧为主的脑萎缩。磁共振血管造影未发现脑血管病变。N-异丙基-[123I]-碘安非他明SPECT显示左半球明显灌注不足，并伴有交叉性小脑失联络。MRS在初始阶段检测到双侧半球N-乙酰天门冬氨酸减少和乳酸信号增加，随后仅右侧恢复正常。这些发现提示急性脑病导致左脑半球脑损伤和神经细胞死亡。SPECT和MRS是研究急性偏瘫综合征病理生理学的有用新技术。
