MedPix® Patient Chart - Case No: 8881 :: Imaging - Review Images

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History

Age: 78 :: Gender: man

Patient History

78 y.o. man with chronic seizure disorder and worsening memory loss.

Exam


Physical Exam and Laboratory

Not available


Findings


Summary of Findings

18-FDG PET images demonstrate decreased cerebral metabolism in the left hippocampus and the bilateral parietal lobes. Coronal T2/Flair MR images demonstrate decreased signal and size of the left hippocampus, relative to the right.


Diffferential


Differential Diagnosis

Multiple infarcts / ischemia
Alzheimer's dementia
Mesial temporal sclerosis


Diagnosis


Case Diagnosis

Dx: Mesial Temporal Hypometabolism (sclerosis)


Dx Confirmed by: Mesial temporal sclerosis by MR and history. Possible Alzheimer dementia suggested, not proven.

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Followup


Followup and Treatment

None available

Discussion


Discussion for this Patient

This case demonstrates how 18-FDG PET can be used for assessment of cerebral metabolism, and corresponding functional deficits. Mesial temporal sclerosis is a well-known cause of refractory seizures. The hypometabolism in the parietal lobes has also been found in patients with Alzheimer's dementia, although often the posterior temporal lobes are involved as well.


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History:
78 y.o. man with chronic seizure disorder and worsening memory loss.

Exam:
Not available


Findings:
18-FDG PET images demonstrate decreased cerebral metabolism in the left hippocampus and the bilateral parietal lobes. Coronal T2/Flair MR images demonstrate decreased signal and size of the left hippocampus, relative to the right.

Differential:
Multiple infarcts / ischemia
Alzheimer's dementia
Mesial temporal sclerosis

Diagnosis:
Mesial Temporal Hypometabolism (sclerosis)
Confirmed by:Mesial temporal sclerosis by MR and history. Possible Alzheimer dementia suggested, not proven.

Treatment and Followup:
None available

Discussion:
This case demonstrates how 18-FDG PET can be used for assessment of cerebral metabolism, and corresponding functional deficits. Mesial temporal sclerosis is a well-known cause of refractory seizures. The hypometabolism in the parietal lobes has also been found in patients with Alzheimer's dementia, although often the posterior temporal lobes are involved as well.

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Case Contributor and Editor

Submitted by: Erik S Storm - Author Info
Case/Image Editor: Frank Schraml - Editor Info
Case Accepted: 2011-11-19 18:31:14-05 :: Revised: 2011-11-19 18:31:44.467834-05 :: Submitted:
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