Reversible posterior leukoencephalopathy syndrome accompanied by eclampsia and mr spectroscopic findings

Posterior leukoencephalopathy syndrome (PLS) is a newly recognised brain disorder that predominantly affects the cerebral white matter. Oedematotıs lesions particularly involve the posterior parietal and occipital lobes, and may spread to basal ganglia, brain stem, and cerebellum. This rapidly evolving neurological condition is clinically characterised by headache, nausea and vomiting, seizures, visual disturbances, altered sensoritım, and occasionally focal neurological deficit. PLS is often associated with an abrupt increase in blood pressure and is usually seen in patients with edampsia, renal disease, and hypertensive encephalojoathy. The lesions of posterior leukoencephalopathy are best visualised with magnetic resonance (MR) imaging. T2 weighted MR images, at the height of symptoms, characteristically show diffuse hyperintensity selectively involving the parieto-occipital white matter. MR spectroscopy (MRS) utilizes the same hardware as MR, but further provides information about the biochemical metabolism. Proton MRS has been used to measure proton-containing compounds, such as amnio acids, organic acids and sugars in tissue specimens. There have been many reports of proton MRS of brain tumors, but this technique has not yet been reported in eclampsia. A 30-vear-old woman complained of diminution of visual acuity, headache and nausea. We measured metabolites in occipital lobes, basal ganglia and posterior parietal lobes using single voxel MRS and evaluated the clinical significance of this method in eclampsia Spectra were analyzed for the presence of choline, creatine. N-acetylaspartate (NAA), lipid, and lactate. This is the first clinical in vivo study that we report a case of reversible PLS accompanied by eclampsia, and spectral findings are descrihed.