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The Findings and Significances of Brain SPECT in Acute Mealses Encephalitis

Journal of the Korean Pediatric Society 2002;45(11):1373-1380.
Published online November 15, 2002.
The Findings and Significances of Brain SPECT in Acute Mealses Encephalitis
Jung Chul Kim, Ju Mi Choung, So Hee Eun, Dae-Yeol Lee, Jung Soo Kim
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
급성 홍역 뇌증 환아들의 뇌 SPECT 소견과 유용성
김정철, 정주미, 은소희, 이대열, 김정수
전북대학교 의과대학 소아과학교실
Correspondence: 
Jung Soo Kim, Email: kimjsp@moak.chonbuk.ac.kr
Abstract
Purpose
: Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME.
Methods
: This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME.
Results
: There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness( 10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : 124±60 mg/dL) and WBC counts(mean : 158±157/μL) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight).
Conclusion
: Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.
Key Words: Acute measles encephalitis, Brain SPECT, MRI, EEG


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