Juvenile-onset Alpers syndrome: interpreting MRI findings.

摘要

A previously healthy 20-year-old woman was admitted to the department of neurology of our hospital after 2 generalized tonic-clonic seizuresin the preceding 2 weeks. Since the first seizure, she had been seeing bright spots. Neurologic examination at admission was normal. EEG showed slowed background activity and continuous epileptic activity in the left occipital lobe. MRI revealed asymmetric but bilateral areas of increased signal intensity in the occipital cortex, most prominent in the left hemisphere (figure, A). During the following weeks, symptoms expanded, as she developed epilepsia partialis con-tinua of her right arm and leg. Repeat brain MRI showed increase and extension of the occipital lesions, now including hyperintensity of the pulvinar region in the left thalamus (figure, B).