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A case of pigmentary orthochromatic leukodystrophy with findings of proton MR spectroscopy and serial brain MRIs.

Authors
Sohn, SY; Ko, YJ; Hong, JM; Kim, SH; Kim, HS; Kim, JH; Chi, JG; Moon, SY
Citation
Journal of the neurological sciences, 295(1-2):23-26, 2010
Journal Title
Journal of the neurological sciences
ISSN
0022-510X1878-5883
Abstract
Despite a few case reports over the last 60 years, little progress has been made in defining the phenotype, genotype and pathophysiological mechanisms involved in pigmentary orthochromatic leukodystrophy (POLD). Furthermore, there is currently no data available regarding MRI in patients in the relatively early stages of POLD. Here, we present a 37 year old male patient with brain biopsy-proven POLD who had brain MRIs three times during the first year of his clinical course and proton MR spectroscopy (MRS) throughout his diagnostic evaluation. This patient with POLD was clinically characterized by seizures, rapidly progressive frontally predominant dementia and gait disturbance. The brain MRIs taken serially over the first year revealed progressive development of frontal-predominant white matter changes in the periventricular areas during the earlier periods, which later spread into the deep white matter. His MRS was helpful in the diagnostic approach because the results enabled demyelinating changes to be distinguished from other disease processes such as ischemia, gliosis or tumors. The MRS findings also reflected the disease dynamics because metabolic derangement was observed, even in the white matter that appeared normal. The findings presented here provide insight into the dynamics of POLD.
MeSH terms
AdultAntigens, CD/metabolismAspartic Acid/analogs & derivativesAspartic Acid/metabolismBrain/metabolismBrain/pathology*Brain Diseases/complicationsBrain Diseases/diagnosis*Brain MappingCreatine/metabolismDemyelinating Diseases/complicationsDemyelinating Diseases/diagnosis*HumansMagnetic Resonance ImagingMagnetic Resonance Spectroscopy*Male
DOI
10.1016/j.jns.2010.05.026
PMID
20547401
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
AJOU Authors
홍지만김세혁김장희문소영
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