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• Vol.58 No.6
• CLINICA NEUROL, 58: 414−417, 2018
• Vol.58 No.6 contents

Brief Clinical Note

Contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging was useful in detecting inflammation of the meninges in neuropsychiatric systemic lupus erythematosus: a case report

Kazuto Tsukita, M.D.¹⁾²⁾, Hirofumi Miyake, M.D.³⁾, Takashi Kageyama, M.D., Ph.D.¹⁾⁴⁾ and Toshihiko Suenaga, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Tenri Hospital
²⁾Department of Neurology, Kyoto University, Graduate School of Medicine
³⁾Department of General Internal Medicine, Tenri Hospital
⁴⁾Department of Neurology, Tokai Memorial Hospital

A 49-year-old woman was admitted to our hospital with recurrent episodes of paresthesia attacks evolving in 5 to 15 minutes from the left hand to the left leg through the left trunk. Neurological examination revealed cortical sensory disturbance in her left hand. Although contrast-enhanced T₁-weighted MRI findings were unremarkable, contrastenhanced fluid-attenuated inversion recovery (FLAIR) MRI revealed abnormal leptomeningeal enhancement over the sulcus of the parietal lobe, including the sulcus around the postcentral gyrus. Because we assumed the cause of the recurrent sensory attack to be meningeal inflammation around the primary somatosensory cortex, we treated this patient by increasing the dose of prednisolone. The increase in prednisolone dose completely resolved the symptom, as well as the abnormal leptomeningeal enhancement on contrast-enhanced FLAIR MRI. In patients with suspected meningeal inflammation, contrast-enhanced FLAIR MRI, which is reported to be more sensitive than contrast-enhanced T₁-weighted MRI in detecting subtle abnormal leptomeningeal enhancement, should be the modality of choice.
Full Text of this Article in Japanese PDF (466K)

(CLINICA NEUROL, 58: 414−417, 2018)
key words: systemic lupus erythematosus (SLE), neuropsychiatric systemic lupus erythematosus (NPSLE), contrast-enhanced fluid-attenuated inversion recovery (FLAIR) MRI

(Received: 3-Apr-18)