Imaging of Toxic and Metabolic Encephalopathy
ASNR 2019 Proceedings
Purpose Clinical diagnosis may be difficult in the early stage of toxic/metabolic encephalopathy. Familiarity with the neuroimaging findings for these diseases may lead to early diagnosis and help improve clinical outcomes. We present a pictorial essay reviewing toxic/metabolic encephalopathies and their imaging features. Materials and Methods A review of cases of toxic/metabolic encephalopathy. The clinical course of the patients was also studied. A literature search on the topic was also performed. A review and comparison of imaging features of different types of toxic/metabolic encephalopathies was compiled. Common, uncommon and rare types of metabolic encephalopathies are included in the pictorial exhibit. Results There are many different types of toxic/metabolic encephalopathies. Our pictorial exhibit includes CT and/or MRI of common, uncommon and rare etiologies of encephalopathy secondary to intrathecal injection of methotrexate, methanol intoxication, Wernicke's encephalopathy, hyperammonemia, hyperglycemia, hepatic encephalopathy, hyperbilirubinemia, carbon monoxide, Wilson disease and acute alcohol intoxication. Conclusions Diagnosis of toxic/metabolic encephalopathy can be challenging especially if history of offending agents cannot be obtained. Familiarity with classical and non classical imaging features can help tailor the diagnosis to improve clinical outcome. In some entities, a specific diagnosis can be strongly suggested and in others, a focused differential diagnosis can be provided.
Memon, F; Kirsch, A; Wang, A; Silbergleit, R; Khan, A; Barry, K; Krishnan, A; Noujaim, S; Wilseck, J; Patel, S; and Tech, K, "Imaging of Toxic and Metabolic Encephalopathy" (2019). Conference Presentation Abstracts. 13.