MRI Findings in a Case of Wilson's Disease with Special Reference to the Lesions in the Thalamus and the Brainstem

Abstract

We reported MRI findings in a 24-year-old woman with Wilson's disease, whose neurological symptoms appeared about 9 months ago. In this early stage of damage of the central nervous system, T2-weighted MR images showed localized high intensity in the lateral portion of the thalamus corresponding to the VL nucleus. This early change in the VL nucleus may have possibly occurred, because this nucleus receives afferent fibers from the basal ganglia and cerebellum which are comparatively vulnerable in this disease. In T2-weighted MR images of the brainstem, there was high intensity in the superior cerebellar peduncle, which may be correlated with the kinetic tremor of this patient, and in broad areas including the tegmentum and the basis of the pons without neurological symptoms. Further examination of cases will be needed, before these characteristic MRI changes, especially those in the VL nucleus can be established as common findings in early stages of this progressive disease.