Nisar A Wani1, Umar A Qureshi2, Majid Jehangir3, Kaiser Ahmad2, Waseem Ahmad2. 1. Department of Pediatric Radiology, Government Medical College Srinagar, Jammu and Kashmir, Pin, 190010, India. ahmad77chinar@gmail.com. 2. Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India. 3. Department of Radiology, Government Medical College Srinagar, Jammu and Kashmir, India.
Abstract
BACKGROUND: Thiamine deficiency in infants is still encountered in developing countries. It may present with acute neurological manifestations of infantile encephalitic beriberi. OBJECTIVE: To review brain MRI findings in infantile encephalitic beriberi from a single institution. MATERIALS AND METHODS: A retrospective review of MRI scans in 22 infants with acute-onset beriberi encephalopathy was carried out. RESULTS: Hyperintense lesions on T2-weighted images were seen symmetrically in the putamen in all patients, in the caudate nuclei in 16/22 (73%), the thalami in 7/22 (32%) and the globi pallidi in 3/22 (14%) of the infants. Altered signal intensity lesions in the cerebral cortex were seen in 7/22 (32%). The mammillary bodies were seen in one infant and the periaqueductal gray matter in two. There was restricted diffusion in 14/22 (64%), and 6/8 children with no evidence of restriction had been imaged ≥10 days after presentation. MR spectroscopy showed increased lactate peak in 6/8 infants (75%). CONCLUSION: Recognition of symmetrical T2-W hyperintense lesions in the basal ganglia with restricted diffusion and prominent lactate peak may allow early diagnosis of encephalitic beriberi in at-risk infants.
BACKGROUND:Thiaminedeficiency in infants is still encountered in developing countries. It may present with acute neurological manifestations of infantile encephalitic beriberi. OBJECTIVE: To review brain MRI findings in infantile encephalitic beriberi from a single institution. MATERIALS AND METHODS: A retrospective review of MRI scans in 22 infants with acute-onset beriberi encephalopathy was carried out. RESULTS: Hyperintense lesions on T2-weighted images were seen symmetrically in the putamen in all patients, in the caudate nuclei in 16/22 (73%), the thalami in 7/22 (32%) and the globi pallidi in 3/22 (14%) of the infants. Altered signal intensity lesions in the cerebral cortex were seen in 7/22 (32%). The mammillary bodies were seen in one infant and the periaqueductal gray matter in two. There was restricted diffusion in 14/22 (64%), and 6/8 children with no evidence of restriction had been imaged ≥10 days after presentation. MR spectroscopy showed increased lactate peak in 6/8 infants (75%). CONCLUSION: Recognition of symmetrical T2-W hyperintense lesions in the basal ganglia with restricted diffusion and prominent lactate peak may allow early diagnosis of encephalitic beriberi in at-risk infants.
Entities:
Keywords:
Basal ganglia; Infantile encephalitic beriberi; Infants; Magnetic resonance imaging; Magnetic resonance spectroscopy; Thiamine; Wernicke encephalopathy
Authors: Douangdao Soukaloun; Sengchanh Kounnavong; Bounthom Pengdy; Boungnong Boupha; Somchai Durondej; Karen Olness; Paul N Newton; Nicholas J White Journal: Ann Trop Paediatr Date: 2003-09
Authors: Carlos A Rugilo; Marcela C Uribe Roca; Maria C Zurru; Arístides A Capizzano; Gustavo A Pontello; Emilia M Gatto Journal: AJNR Am J Neuroradiol Date: 2003-05 Impact factor: 3.825
Authors: G Zuccoli; M Gallucci; J Capellades; L Regnicolo; B Tumiati; T Cabada Giadás; W Bottari; J Mandrioli; M Bertolini Journal: AJNR Am J Neuroradiol Date: 2007-08 Impact factor: 3.825
Authors: Christine Luxemburger; Nicholas J White; Feiko ter Kuile; H M Singh; Irène Allier-Frachon; Mya Ohn; Tan Chongsuphajaisiddhi; François Nosten Journal: Trans R Soc Trop Med Hyg Date: 2003 Mar-Apr Impact factor: 2.184
Authors: Majid Alfadhel; Makki Almuntashri; Raafat H Jadah; Fahad A Bashiri; Muhammad Talal Al Rifai; Hisham Al Shalaan; Mohammed Al Balwi; Ahmed Al Rumayan; Wafaa Eyaid; Waleed Al-Twaijri Journal: Orphanet J Rare Dis Date: 2013-06-06 Impact factor: 4.123
Authors: Javeed Iqbal Bhat; Hilal Ahmad Rather; Ambreen Ali Ahangar; Umar Amin Qureshi; Parvez Dar; Qazi Iqbal Ahmed; Bashir Ahmed Charoo; Syed Wajid Ali Journal: Indian Heart J Date: 2016-08-02