Infantile encephalitic beriberi: magnetic resonance imaging findings.
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.


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%).


CONCLUSIONS
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.
Department of Pediatric Radiology, Government Medical College Srinagar, Jammu and Kashmir, Pin, 190010, India. ahmad77chinar@gmail.com.
Nisar A
NA
Wani
Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India.
Umar A
UA
Qureshi
Department of Radiology, Government Medical College Srinagar, Jammu and Kashmir, India.
Majid
M
Jehangir
Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India.
Kaiser
K
Ahmad
Department of Pediatrics, Government Medical College Srinagar, Jammu and Kashmir, India.
Waseem
W
Ahmad
D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014899:Wernicke Encephalopathy / Q000473:pathology*
Basal ganglia; Infantile encephalitic beriberi; Infants; Magnetic resonance imaging; Magnetic resonance spectroscopy; Thiamine; Wernicke encephalopathy