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American Journal of Neuroradiology 23:833-837, May 2002
© 2002 American Society of Neuroradiology

Case Report
BRAIN

Diffuse Metabolic Abnormalities in Reversible Posterior Leukoencephalopathy Syndrome

Florian S. Eichler^a, Paul Wang^b, Robert J. Wityk^c, Norman J. Beauchamp, Jr^b and Peter B. Barker^b

^a Department of Neurogenetics, The Johns Hopkins University, Baltimore, MD
^b Kennedy Krieger Institute, and the Departments of Radiology The Johns Hopkins University, Baltimore, MD
^c Department of Neurology, The Johns Hopkins University, Baltimore, MD

Address reprint requests to Peter B. Barker, PhD, Department of Radiology, MRI 143C, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287

Summary: Two cases of reversible posterior leukoencephalopathy syndrome were examined with proton MR spectroscopic imaging. Widespread metabolic abnormalities, consisting of increased choline and creatine levels and mildly decreased N-acetylaspartate, occurred in regions with both normal and abnormal MR imaging appearances. In one case for which proton MR spectroscopic imaging follow-up was available, all metabolite levels had returned to normal by 2 months. Proton MR spectroscopic imaging may be helpful for the diagnosis and investigation of the underlying pathophysiology of reversible posterior leukoencephalopathy syndrome.

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