Female, 10 years old, with myoclonic jerks in the upper extremities, intermittent dementia and mutism, concern for encephalitis. The cerebral and cerebellar hemispheres and brainstem show normal signal intensity and morphology. No restricted diffusion is seen. No pathologic parenchymal or extra-axial enhancement is noted.No evidence of parenchymal edema, mass, or mass effect is seen. There is no evidence of intracranial hemorrhage or abnormal extra-axial fluid. The ventricular system is normal in caliber and morphology. The mesial temporal lobe structures are symmetric and normal. Single voxel MR spectra obtained over the mesial temporal lobes show normal metabolite patterns. Likewise, multi voxel spectroscopy performed over a larger region of the temporal lobes shows no significant abnormality.Signal intensity of the bone marrow is unremarkable. No significant abnormalities of the paranasal sinuses are detected.
Unremarkable evaluation with no specific findings on conventional MR images or on MR spectroscopy to account for the patient's symptoms.