Clinical manifestation and treament analysis of 28 cases of toxic encephalopathy

Objective To study the clinical manifestation and MRI feature of toxic encephalopathy caused by different reasons,and discuss the treatment.Methods Retrospective analysis of the 28 cases of toxic encephalopathy in our hospital from March 2003 to Jan 2013 who suffered by different toxic substance,in order to observe the clinical manifestation,MRI feature and clinical therapeutic effect of them.Results All of the 28 cases were seen long T1 and long T2 signal intensity in the white matter,deep nucleus,and gray matter by MRI.And 13 cases of acute toxic encephalopathy showed T 1-weighted images,which suggesting vasogenic edema,while long intensity in DWI images means cytotoxic edema.Of 28 cases,13 cases were presented positive effect (cerebral edema),10 cases were manifested headache,vomit and papilloedema(76.9％),8 cases were seizure(61.5％).And 11 cases were clinically cured (84.6％) by dehydration and dexamethasone,and 2 cases were dead due to short-time dehydration and untimely drug withdrawal (15.4％).The other 15 cases were presented negative effect (encephalatrophy),11 cases were bad-response and declined memory(73.3％),8 cases were limb tremor and walking instability(53.3％).All of the 15 cases were cured.Conclusion The toxic encephalopathy caused by different reasons have specific imaging features,and exist both intracellular and extracellular edema,so an early,longrange and full-dose treatment of dehydration and dexamethasone should be useful. Key words: Toxic encephalopathy; Clinical manifestation; MRI; Treatment