{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:36:06Z","timestamp":1787841366738,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There are numerous toxins that affect our nervous system, both central and peripheral. Innumerable differentials exist in patients of acute encephalopathy and the list can be narrowed down with appropriate imaging. Specific neuroradiological features point to a particular diagnosis in a substantial number of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Through this study, we aimed to demonstrate the varied imaging findings of toxic encephalopathy on MRI encountered at our institute.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of the patients clinically diagnosed as toxic encephalopathy and referred for imaging between March 2015 and December 2019 was done. A total of 25 patients were included. Patient records were reviewed for clinical details, laboratory investigations, and treatment; the institute Picture Archiving and Communication System provided the imaging findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients presenting were aged between 22 and 55 years (mean\u201434.3 years). Four patients (16%) presented with imaging findings characteristic of Marchiafava-Bignami disease and six patients (24%) had MRI findings of Wernicke encephalopathy. Three patients (12%) had methanol poisoning sequelae while imaging findings of nitroimidazole drug toxicity were observed in another three patients (12%). Two patients (8%) each of carbon monoxide poisoning and lead toxicity were seen. We had one patient (4%) each of isoniazid, methyl iodide, dextropropoxyphene toxicity, chronic toluene abuse, and hyperglycemia-induced hemiballismus-hemichorea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study illustrates the amalgamated spectrum of MRI appearances in various subgroups of toxic encephalopathies. Imaging substantiated by relevant history and clinical manifestations can accurately diagnose the possible causative agent in the majority of the cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.355127","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:36:16Z","timestamp":1664152576000},"page":"1525-1533","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["MRI Spectrum of Toxic Encephalopathy\u2014An Institutional Experience"],"prefix":"10.4103","volume":"70","author":[{"given":"Shamick","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hima S","family":"Pendharkar","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek S","family":"Murumkar","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"R1-20250921","first-page":"121","article-title":"Toxic and metabolic encephalopathies: Iconographic essay","volume":"48","author":"Bimbato","year":"2015","journal-title":"Radiologiabrasileira"},{"key":"R2-20250921","doi-asserted-by":"crossref","first-page":"879","DOI":"10.2214\/AJR.08.2257","article-title":"Toxic and acquired metabolic encephalopathies: MRI appearance","volume":"193","author":"Sharma","year":"2009","journal-title":"Am J Roentgenol"},{"key":"R4-20250921","doi-asserted-by":"crossref","first-page":"649","DOI":"10.4103\/0028-3886.57811","article-title":"Marchiafava-Bignami disease: Role of neuroimaging in the diagnosis and management of acute disease","volume":"57","author":"Bano","year":"2009","journal-title":"Neurol India"},{"key":"R5-20250921","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.2214\/AJR.09.4130","article-title":"Neuroimaging findings in alcohol-related encephalopathies","volume":"195","author":"Zuccoli","year":"2010","journal-title":"Am J Roentgenol"},{"key":"R6-20250921","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3349\/ymj.2007.48.2.321","article-title":"Acute Marchiafava-Bignami disease: Diffusion-weighted MRI in cortical and callosal involvement","volume":"48","author":"Ihn","year":"2007","journal-title":"Yonsei Med J"},{"key":"R7-20250921","article-title":"Magnetic resonance imaging in Marchiafava-Bignami syndrome: a cornerstone in diagnosis and prognosis","author":"Paidipati Gopalkishna Murthy","year":"2014","journal-title":"Case reports in radiology, 2014 Sep 23"},{"key":"R8-20250921","doi-asserted-by":"crossref","first-page":"503596","DOI":"10.1155\/2014\/503596","article-title":"MR imaging findings in alcoholic and nonalcoholic acute Wernicke's encephalopathy: A review","volume":"2014","author":"Manzo","year":"2014","journal-title":"Biomed Res Int"},{"key":"R9-20250921","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.3174\/ajnr.A0544","article-title":"Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients","volume":"28","author":"Zuccoli","year":"2007","journal-title":"Am J Neuroradiol"},{"key":"R10-20250921","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3174\/ajnr.A1280","article-title":"MR imaging findings in 56 patients with Wernicke encephalopathy: Nonalcoholics may differ from alcoholics","volume":"30","author":"Zuccoli","year":"2009","journal-title":"Am J Neuroradiol"},{"key":"R11-20250921","doi-asserted-by":"crossref","first-page":"501","DOI":"10.2214\/AJR.07.3959","article-title":"Neuroimaging findings in acute Wernicke's encephalopathy: Review of the literature","volume":"192","author":"Zuccoli","year":"2009","journal-title":"Am J Roentgenol"},{"key":"R12-20250921","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1081\/CLT-120006745","article-title":"American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning","volume":"40","author":"Barceloux","year":"2002","journal-title":"J Toxicol Clin Toxicol"},{"key":"R13-20250921","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1136\/jnnp.2009.178897","article-title":"Reversible cerebellar toxicity during treatment with ornidazole: The first case report","volume":"81","author":"Taskapilioglu","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R14-20250921","first-page":"1615","article-title":"MR imaging and diffusion-weighted imaging changes in metronidazole (flagyl)\u2013induced cerebellar toxicity","volume":"24","author":"Heaney","year":"2003","journal-title":"Am J Neuroradiol"},{"key":"R15-20250921","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/S0750-7658(84)80127-6","article-title":"Peripheral neuropathy during treatment with ornidazole","volume":"3","author":"Desbordes","year":"1984","journal-title":"Ann Fr Anesth Reanim"},{"key":"R16-20250921","first-page":"1845","article-title":"Pallidoreticular damage in acute carbon monoxide poisoning: Diffusion-weighted MR imaging findings","volume":"26","author":"Kinoshita","year":"2005","journal-title":"Am J Neuroradiol"},{"key":"R17-20250921","first-page":"1475","article-title":"Acute carbon monoxide poisoning: Diffusion MR imaging findings","volume":"24","author":"Sener","year":"2003","journal-title":"AJNR Am J Neuroradiol"},{"key":"R18-20250921","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4103\/0971-3026.120253","article-title":"MRI brain in monohalomethane toxic encephalopathy: A case report","volume":"23","author":"Deshmukh","year":"2013","journal-title":"Indian J Radiol Imaging"},{"key":"R19-20250921","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.4103\/neuroindia.NI_249_17","article-title":"Isoniazid toxicity presenting as bilateral dentate hyperintensities","volume":"65","author":"Deepesh","year":"2017","journal-title":"Neurology India"},{"key":"R20-20250921","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.11622\/smedj.2013188","article-title":"Isoniazid-induced cerebellitis: A disguised presentation","volume":"55","author":"Peter","year":"2014","journal-title":"Singapore Med J"},{"key":"R21-20250921","first-page":"2014","article-title":"Pb neurotoxicity: neuropsychological effects of lead toxicity","author":"Mason","year":"2014","journal-title":"BioMed research international"},{"key":"R22-20250921","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2214\/ajr.146.2.267","article-title":"Intracranial calcification in adults with chronic lead exposure","volume":"146","author":"Reyes","year":"1986","journal-title":"Am J Roentgenol"},{"key":"R23-20250921","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1159\/000098100","article-title":"Burton's line in lead poisoning","volume":"57","author":"Pearce","year":"2007","journal-title":"Eur Neurol"},{"key":"R24-20250921","first-page":"902","article-title":"Pre-and posttreatment MR imaging findings in lead encephalopathy","volume":"27","author":"Atre","year":"2006","journal-title":"Am J Neuroradiol"},{"issue":"3","key":"R25-20250921","first-page":"RC01","article-title":"Hyperglycemic Nonketotic Hemichorea-Hemiballismus-Case Report with Review of Literature","volume":"5","author":"Swarna","year":"2016","journal-title":"International Journal of Anatomy, Radiology and Surgery"},{"key":"R26-20250921","first-page":"128037","article-title":"Nonketotic hyperglycemic chorea","volume":"2014","author":"Abdelghany","year":"2014","journal-title":"Case Rep Neurol Med"},{"key":"R27-20250921","doi-asserted-by":"crossref","first-page":"143","DOI":"10.12659\/AJCR.890179","article-title":"Chorea, hyperglycemia, basal ganglia syndrome (CH-BG) in an uncontrolled diabetic patient with normal glucose levels on presentation","volume":"15","author":"Bizet","year":"2014","journal-title":"Am J Case Rep"},{"key":"R28-20250921","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5530\/ijmedph.2017.3.36","article-title":"An unusual presentation of spasmoproxyvon dependence from Manipur, India","volume":"7","author":"Singh","year":"2017","journal-title":"Int J Med Public Health"},{"key":"R29-20250921","first-page":"1173","article-title":"Cranial MR findings in chronic toluene abuse by inhalation","volume":"23","author":"Aydin","year":"2002","journal-title":"AJNR Am J Neuroradiol"},{"key":"R30-20250921","first-page":"1643","article-title":"White matter changes caused by chronic solvent abuse","volume":"16","author":"Yamanouchi","year":"1995","journal-title":"Am J Neuroradiol"}],"container-title":["Neurology India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.355127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:51:41Z","timestamp":1787838701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.355127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/0028-3886.355127","relation":{},"ISSN":["0028-3886","1998-4022"],"issn-type":[{"value":"0028-3886","type":"print"},{"value":"1998-4022","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2020-04-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}