Rasmussen syndrome: multifocal spread of inflammation suggested from MRI and PET findings.
BACKGROUND
A 6-year-old girl with Rasmussen syndrome (RS) showed multiple small high-signal-intensity areas independently in the right hemisphere by fluid-attenuated inversion recovery (FLAIR) imaging on magnetic resonance imaging (MRI) 1 year after the onset of epilepsy.


METHODS
MRI performed 4 months later demonstrated a further increase in the number of these foci and enlargement in the size of the previous FLAIR lesions.


RESULTS
An [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) study showed a strong, spotty uptake in the right temporooccipital regions, corresponding to the sites of continuous EEG seizure discharges. In contrast, [11C]methionine PET demonstrated multifocal uptake regions, which corresponded anatomically to the FLAIR lesions, suggesting sites of underlying chronic inflammation.


CONCLUSIONS
These neuroimaging findings suggested that the inflammatory process in RS spreads either multifocally at the same time, as seen in this case, or from one discrete area to the adjacent region, as reported previously.
Maeda
Yumi
Y
Department of Pediatrics, Tokyo Woman's Medical University, Tokyo, Japan.
Oguni
Hirokazu
H
Saitou
Yoshiaki
Y
Mutoh
Ayako
A
Imai
Kaoru
K
Osawa
Makiko
M
Fukuyama
Yukio
Y
Hori
Tomokatsu
T
Yamane
Fumitaka
F
Kubo
Osamu
O
Ishii
Kenji
K
Ishiwata
Kiichi
K
D001342:Autonomic Nervous System Diseases / Q000175:diagnosis; D002250:Carbon Radioisotopes; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D018450:Disease Progression; D004292:Dominance, Cerebral / Q000502:physiology*; D004660:Encephalitis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D017036:Epilepsia Partialis Continua / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D004827:Epilepsy; D020938:Epilepsy, Partial, Motor / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008715:Methionine; D009778:Occipital Lobe / Q000473:pathology / Q000503:physiopathology; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology; D014055:Tomography, Emission-Computed
D002250:Carbon Radioisotopes; D019788:Fluorodeoxyglucose F18; D008715:Methionine