case_images: PMC9237385_01
case_images: Brain images. (A) CT scan showed bilateral symmetric basal ganglia low density. Brain MRIs showed low signal intensities in the bilateral symmetric putamen in T1 (B), and high signal intensities in T2 (C), Axial FLAIR (D), diffusion weighted image (E), apparent diffusion coefficient (F) over the same regions.
case_images: fmed-09-918812-g0001.jpg
case_images: PMC9237385_01_fmed-09-918812-g0001.jpg
case_images: F1
case_images: CT scan showed low signal intensities in bilateral basal ganglia (Figure 1A) and pulmonary infection. Brain magnetic resonance images (MRIs) demonstrated abnormal signal intensity in the bilateral symmetric putamen (Figures 1B-F).
case_images: Optic nerve MRIs: T1 (A) and T2 (B) showed increased signal of bilateral optic nerve, especially the left one with thickening. (C) Pupillary light reflex showed both eyes are insensitive to light. Visual evoked potentials demonstrated prolonged latent time of P100 and decreased amplitude of wave in the right eye (D,F), and no clear waveforms of P100 were elicited in the left (E,G). Fundus examination revealed bilateral optic disc swelling (H,I), especially the right one (H). Fundus fluorescein angiography demonstrated no fluorescein leakage (J) and (K) for left and right respectively).
case_images: fmed-09-918812-g0002.jpg
case_images: PMC9237385_01_fmed-09-918812-g0002.jpg
case_images: F2
case_images: Optic nerve MRIs illustrated optic neuropathy (Figures 2A,B). Pupillary light reflex showed that both were insensitive to light (Figure 2C). Visual evoked potentials revealed visual pathway impairment, and optic nerve demyelination with axonal deterioration, which was more severe on the left side (Figures 2D-G). Fundus examination revealed features of toxic neuropathy with bilateral optic disc hyperemia and swelling (Figures 2H,I), and fundus fluorescein angiography showed no fluorescein leakage (Figures 2J,K).