Proton MR spectroscopy in the diagnosis of early-stage subacute sclerosing panencephalitis

Subacute sclerosing panencephalitis (SSPE) is a progressive, fatal neurological disorder of childhood and early adolescence. In this report, we present brain magnetic resonance spectroscopy (MRS) and conventional magnetic resonance MR imaging findings of early-stage (stage II) SSPE in an 8-year-old child. MRS demonstrated increased myo-inositol/creatine and choline/creatine ratios, and a decreased N-acetyl aspartate/creatine ratio. Conventional MR imaging demonstrated nonspecific, patchy T2 hyperintensities in the periventricular white matter and a nonspecific focus of T2 hyperintensity in the right frontal subcortical white matter. The MRS findings suggested active inflammation and demyelination as is seen in early-stage SSPE.