title: Serial MR spectroscopy in relapsing reversible posterior leukoencephalopathy syndrome.
abstract: BACKGROUND
  Reversible posterior leukoencephalopathy syndrome (RPLS) in atypical locations is difficult to diagnose. Magnetic resonance spectroscopy (MRS) can help, but results to date are discrepant. We aimed to describe MRS findings in each phase of RPLS and evaluate their diagnostic potential.
  
  
  METHODS
  We performed MRS, diffusion-weighted imaging and conventional MR during 2 episodes in a patient with hypertensive encephalopathy.
  
  
  RESULTS
  There were multifocal edematous lesions in both frontal lobes, the left temporo-occipital region and both cerebellar hemispheres in the first episode, and in both cerebellar hemispheres and the left pons in the second. Apparent diffusion coefficient values were high. Choline was normal in the acute phase and elevated in the subacute period. N-acetylaspartate was low throughout, even after clinical recovery and disappearance of the lesion on conventional MR. No lactate peak was detected.
  
  
  CONCLUSIONS
  MRS helps differentiate RPLS from several encephalopathies and a N-acetylaspartate decrease does not predict a poor outcome.
authors.affiliation: Department of Neurology, Kangwon National University, Kangwon-Do, Korea.
authors.forename: Seo-Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Sung Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Baek
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Shon
authors.forename: Sam Soo
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D010725:Phosphocreatine / Q000378:metabolism; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D010725:Phosphocreatine; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine