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Migrainous syndrome with CSF pleocytosis. SPECT findings
A B Caminero1, J A Pareja, J Arpa
1Unidad de Neurología, Hospital Ntra. Sra. de Sonsoles, Avila, Spain.
Headache
|November 5, 1997
Summary
Brain SPECT scans revealed reduced tracer uptake in three out of four patients with transient neurological deficits and cerebrospinal fluid (CSF) pleocytosis, suggesting impaired neuronal metabolism or blood flow.
Area of Science:
- Neurology
- Neuroimaging
Background:
- Transient neurological deficits with cerebrospinal fluid (CSF) pleocytosis present a diagnostic challenge.
- Understanding the underlying neurobiological mechanisms is crucial.
Purpose of the Study:
- To investigate brain perfusion and neuronal metabolism using SPECT in patients with this transient syndrome.
- To correlate neuroimaging findings with clinical and EEG data.
Main Methods:
- Four adult patients with transient neurological deficits and CSF pleocytosis underwent technetium Tc 99m hexamethyl propylenamine oxime (HMPAO) brain SPECT.
- SPECT scans were performed during symptom-free periods, 8-25 days post-symptom onset.
- Findings were correlated with neurological examination and electroencephalography (EEG) results.
Main Results:
- Three patients demonstrated decreased HMPAO tracer uptake in the anterior left hemisphere.
- The SPECT abnormalities corresponded topographically with neurological deficits and EEG focal slowing.
- One patient exhibited normal SPECT findings.
Conclusions:
- Brain SPECT may reveal focal hypoperfusion or impaired neuronal metabolism in this syndrome.
- These neuroimaging abnormalities could be related to the clinical presentation.
- The role of SPECT findings as either a direct correlate or epiphenomenon requires further investigation.