Myoclonus and past medical history of cerebellar lesions from encephalitis. Evaluate for etiology of myoclonus. Brain MRI:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is moderate atrophy involving the bilateral cerebellar hemispheres but no abnormal signal intensity is visualized. The post-contrast exam is motion degraded which limits full evaluation, but there is no obvious abnormal enhancement. The remaining brain parenchyma and pituitary gland appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is right maxillary sinus and frontoethmoidal sinus mucosal thickening. There is also a left mucous retention cyst or polyp. Cervical spine MRI:Craniovertebral junction appears within normal limits. There is straightening of the cervical spine which is nonspecific. The cervical vertebral bodies are appropriate in height. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: There is a small disc bulge without significant compromise to the spinal canal or neural foramina.C3-4: There is a small disc bulge without significant compromise to the spinal canal or neural foramina.C4-5: There is a tiny disc bulge without significant compromise to the spinal canal or neural foramina.C5-6: There is a mild disc bulge and mild uncovertebral and facet hypertrophy which causes mild right neural foraminal stenosis. No significant compromise to the spinal canal or left neural foramina.C6-7: There is a mild disc bulge and mild uncovertebral and facet hypertrophy without significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1.Diffuse bilateral cerebellar hemispheric atrophy which is nonspecific and may be related to the prior history of encephalitis as stated in the history.2.Mild degenerative changes of the cervical spine without cord signal abnormality or high-grade spinal canal or neural foraminal stenosis at any level.