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Differential diagnosis for toxic/metabolic encephalopathies - Patterns on Brain Imaging

Cynthia Czawlytko, MD @drcyncity

#Differential #diagnosis #encephalopathies #encephalopathy
for toxic/metabolic ... encephalopathies #encephalopathy ... #patterns #MRI ... #Neurology #pathology ... #diseases #radiology
Imaging Patterns of Toxic and Metabolic Brain Disorders

Thalami, Mammillary Bodies and Tectum: Wernicke Encephalopathy
Dentate Nuclei: Metronidazole,
Brain Disorders ... Pons: ODS #MRI ... #Clinical #Differential ... #Diagnosis #Radiology ... #Neurology
Peri-operative Hyperthermia - Guidelines for Crises in Anaesthesia
If prolonged or ≥ 39 C this is a
dissipation of metabolic ... Phaeochromocytoma Neurologic ... blood • Hypoxic encephalopathy ... • Traumatic brain ... #Hyperthermia #Differential
Hypokalemia Evaluation Algorithm

Before evaluating hypokalemia, life threatening complications such as arrhythmias and paralysis should be looked
wasting from other causes ... A urine K/Cr ratio ... • Diarrhea A urine ... diagnosis #Algorithm #differential ... #potassium #nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm
Cl- responsive metabolic alkalosis
 • Kidney loss of Cl-
, Gitelman syndrome ... concentration can be ... the indicated causes ... #Algorithm #nephrology ... #differential #
BEE Syndromes - Non-inflammatory Causes

Immune-mediated conditions affecting the Brain, Eye, and Ear

Visual or auditory symptoms in
BEE Syndromes - ... affecting the Brain ... neuropathy (LHON) plus MRI ... #Syndromes #neurology ... noninflammatory #differential
CNS Ring-Enhancing Lesions - Immunocompromised vs Immunocompetent
Multiple Ring-Enhancing Lesions:
 • Toxoplasmosis (CD4 < 100)
 • Other
Diagnosis- Compatible syndrome ... + MRI lesions + ... #differential # ... diagnosis #causes ... #radiology #neurology
Posterior Reversible Encephalopathy Syndrome (PRES) Overview

Clinico-Radiological Syndrome, characterized by:
 • Headache
 • Seizures
 • Altered mental
Posterior Reversible Encephalopathy ... parietal lobes of the brain ... may precede the neurologic ... Reversible course Differential ... Drug toxicity, Metabolic
Causes of Status Epilepticus in Adults
METABOLIC DISTURBANCES
Hepatic encephalopathy
Hypocalcemia
Hypoglycemia or hyperglycemia
Hyponatremia
Uremia
INFECTIOUS PROCESSES
Central nervous system abscess
Encephalitis
Meningitis
WITHDRAWAL SYNDROMES
Alcohol
Antiepileptic drugs
Baclofen
Barbiturates
Benzodiazepines
CENTRAL
Epilepticus in Adults METABOLIC ... DISTURBANCES Hepatic encephalopathy ... Meningitis WITHDRAWAL SYNDROMES ... malformations Brain ... #neurology