Loss of speech after living-related donor liver transplantation: detection of the lesion by diffusion tensor image.
BACKGROUND
Loss of speech after living-related liver transplantation is uncommon. Either immunosuppressive agents, related sequelae, or a neurological event may cause it.


METHODS
A 46-year-old man developed dysarthria and dysphagia on the 10th day after living-related donor liver transplantation for alcoholic cirrhosis with Child-Pugh class C. Brain magnetic resonance images and electroencephalograms could not detect any lesion, but the diffusion tensor image showed a subacute lacunar infarction at right midbrain. The patient's speech improved 1 month after rehabilitation.


CONCLUSIONS
Some unexpected neurological events, such as loss of speech, may occur after liver transplantation. The differential diagnosis becomes very important before active treatment. Magnetic resonance imaging supplemented with diffusion tensor imaging is an effective imaging study in establishing the diagnosis.
Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan. Electronic address: kevin.ksjeng@gmail.com.
K S
KS
Jeng
Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.
S H
SH
Chu
Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan.
C C
CC
Huang
Division of Gastroenterology, Far Eastern Memorial Hospital, Taipei, Taiwan.
C K
CK
Lin
Division of Gastroenterology, Far Eastern Memorial Hospital, Taipei, Taiwan.
C C
CC
Lin
Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.
K H
KH
Chen
D001044:Aphonia / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D004569:Electroencephalography; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged