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Reversible diffusion MRI abnormalities and transient mutism after liver transplantation
F Bianco1, F Fattapposta, N Locuratolo
1Department of Neurology, Neuroradiology Unit, General Surgery and Transplantation, University of Rome "La Sapienza," Italy. federico.bianco@uniroma1.it
Neurology
|March 24, 2004
Summary
A liver transplant patient experienced temporary mutism linked to cyclosporine A and amphotericin B. Reversible brain MRI abnormalities, likely edema, resolved after adjusting the patient's medication.
Area of Science:
- Neurology
- Nephrology
- Immunology
Background:
- Cyclosporine A is a common immunosuppressant post-liver transplant.
- Amphotericin B is used for antifungal prophylaxis.
- Transient neurological symptoms can occur in transplant patients.
Purpose of the Study:
- To report a case of transient mutism in a liver transplant patient.
- To investigate the potential causes and imaging findings associated with this neurological event.
Main Methods:
- Case report of a liver transplant patient.
- Magnetic Resonance Imaging (MRI) including Fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI).
Main Results:
- Transient mutism was observed.
- MRI revealed reversible bilateral symmetric hyperintensity in the frontal motor cortex and corticospinal tracts.
- Abnormalities resolved with therapeutic change.
Conclusions:
- Cyclosporine A and amphotericin B therapy may be associated with transient neurological deficits.
- Acute cerebral edema, potentially mixed cytotoxic and vasogenic, is a likely cause.
- Prompt modification of immunosuppressive and antifungal therapy can lead to resolution.