Acute leukoencephalopathy with restricted diffusion

Case contributed by Ali Alsmair
Diagnosis probable


The patient presented with with high-grade fever, seizures, unconsciousness.

Patient Data

Age: 13 months
Gender: Male

There is subtle symmetric T2/FLAIR hyperintensity involving the bilateral frontal white matter and bilateral frontal and right occipital grey matter.

Case Discussion

The marked diffusion restriction on DW images can be seen as subtle changes on the conventional sequences such as T1, T2, and FLAIR images, and this is a characteristic finding of acute leukoencephalopathy with restricted diffusion (ALERD).

Infection (mostly viral infection) and toxins are the most common causes of this entity.

Treatment is usually supportive (including IVIG and IV steroids) with the treatment of seizures 1.

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