Radiological Insights into Acute Leukoencephalopathy with Restricted Diffusion: A Case Series Analysis

Area of Science:

• Pediatric Neurology
• Neuroradiology
• Infectious Diseases

Background:

• Acute encephalopathy, seizures, and fever are common in pediatric patients.
• Acute leukoencephalopathy with restricted diffusion (ALERD) is a specific neurological condition requiring accurate diagnosis.
• Understanding ALERD's clinical and radiological features is crucial for effective management.

Purpose of the Study:

• To investigate the clinical and radiological characteristics of ALERD in pediatric patients.
• To identify diagnostic patterns of ALERD using magnetic resonance imaging (MRI).
• To differentiate ALERD from other causes of acute encephalopathy.

Main Methods:

• Retrospective analysis of 48 pediatric patients with acute encephalopathy, fever, and seizures.
• Inclusion of patients with MRI evidence of acute subcortical white matter involvement.
• Collection and analysis of clinical, radiological, and laboratory data.

Main Results:

• 18.7% of cases met ALERD criteria, predominantly in male children (mean age 32 months).
• Identified biphasic/monophasic clinical courses and two patterns of brain involvement: diffuse and central-sparing.
• MRI, especially diffusion-weighted imaging, revealed characteristic restricted diffusion patterns crucial for ALERD diagnosis.

Conclusions:

• ALERD is a distinct clinical-radiological syndrome often associated with infections.
• Recognizing ALERD's varied presentations and MRI findings improves diagnostic accuracy and patient outcomes.
• Timely diagnosis and management of ALERD are facilitated by understanding its specific characteristics.