Related Experiment Video
Updated: Aug 29, 2025
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
MRI Spectrum of Toxic Encephalopathy-An Institutional Experience
Shamick Biswas1, Hima S Pendharkar1, Vivek S Murumkar1
1Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
Background:
There are numerous toxins that affect our nervous system, both central and peripheral. Innumerable differentials exist in patients of acute encephalopathy and the list can be narrowed down with appropriate imaging. Specific neuroradiological features point to a particular diagnosis in a substantial number of cases.
Objective:
Through this study, we aimed to demonstrate the varied imaging findings of toxic encephalopathy on MRI encountered at our institute.
Material And Methods:
A retrospective analysis of the patients clinically diagnosed as toxic encephalopathy and referred for imaging between March 2015 and December 2019 was done. A total of 25 patients were included. Patient records were reviewed for clinical details, laboratory investigations, and treatment; the institute Picture Archiving and Communication System provided the imaging findings.
Results:
Patients presenting were aged between 22 and 55 years (mean-34.3 years). Four patients (16%) presented with imaging findings characteristic of Marchiafava-Bignami disease and six patients (24%) had MRI findings of Wernicke encephalopathy. Three patients (12%) had methanol poisoning sequelae while imaging findings of nitroimidazole drug toxicity were observed in another three patients (12%). Two patients (8%) each of carbon monoxide poisoning and lead toxicity were seen. We had one patient (4%) each of isoniazid, methyl iodide, dextropropoxyphene toxicity, chronic toluene abuse, and hyperglycemia-induced hemiballismus-hemichorea.
Conclusion:
Our study illustrates the amalgamated spectrum of MRI appearances in various subgroups of toxic encephalopathies. Imaging substantiated by relevant history and clinical manifestations can accurately diagnose the possible causative agent in the majority of the cases.
Insights
MRI reveals diverse toxic encephalopathy patterns, aiding diagnosis. Specific imaging features help identify causative toxins affecting the central and peripheral nervous systems.
Area of Science:
- Neuroradiology
- Neurology
- Toxicology
Background:
- Numerous toxins impact the central and peripheral nervous systems.
- Acute encephalopathy presents with many differentials, often narrowed by imaging.
- Specific neuroradiological findings can indicate particular toxic diagnoses.
Purpose of the Study:
- To demonstrate the varied magnetic resonance imaging (MRI) findings of toxic encephalopathy.
- To showcase the spectrum of imaging presentations encountered in clinical practice.
Main Methods:
- Retrospective analysis of 25 patients with toxic encephalopathy from March 2015 to December 2019.
- Review of clinical details, laboratory data, and treatment records.
- Analysis of MRI findings obtained from the Picture Archiving and Communication System.
Main Results:
- Diverse etiologies identified, including Marchiafava-Bignami disease (16%), Wernicke encephalopathy (24%), methanol poisoning (12%), and nitroimidazole toxicity (12%).
- Other causes included carbon monoxide poisoning (8%), lead toxicity (8%), isoniazid, methyl iodide, dextropropoxyphene toxicity, chronic toluene abuse, and hyperglycemia-induced hemiballismus-hemichorea (4% each).
- Patient ages ranged from 22 to 55 years, with a mean of 34.3 years.
Conclusions:
- MRI displays a wide range of appearances for various toxic encephalopathies.
- Integrating imaging findings with clinical history and manifestations aids in accurate diagnosis of the causative agent.
Related Concept Videos
01:24Magnetic Resonance Imaging
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...