Presentation
Seizures.
Patient Data
Symmetrical bilateral increased signal intensity of the globus pallidus on T1WI with signal drop in gradient echo images indicating mineral deposition. No evidence of diffusion restriction is seen.
Otherwise normal brain, brain stem, and cerebellar signal.
No evidence of intracranial masses or mass effect.
Normal ventricular system and sulci.
Symmetrical hippocampus without signal abnormality.
Post gadolinium contrast images show no abnormal parenchymal or meningeal enhancement.
Case Discussion
This 20-year old is known to have Wilson's disease presenting through ER after an episode of seizures. T1 hyperintensity, especially in the globus pallidus is the most common initial signal abnormality in Wilson`s disease.
The putamina did not show a signal abnormality on T2WI, which is the most common signal abnormality in patients with Wilson's disease.
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