Clinical manifestations of radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma and their comparative ana

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Clinical manifestations of radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma and their comparative analysis with MRI

In order to probe into an optimal method for locating radiation encephalopathy (REP) after radiotherapy for nasopharyngeal carcinoma (NC), 84 consecutive patients with REP who were treated in Nanfang Hospital were observed and their clinical data analysed in comparison with the findings from magnetic resonance imaging (MRI)from 1986 through 1993. The results showed that the early symptoms and signs of REP are mainly mental symptoms due to lesions of the temporal lobes, and signs of the pyramidal tract and cranial nerve lesion syndromes which are associated with brain-stem injury. The clinical features of REP might be classified into 3 stages: early response, state of relative rest and delayed response in the light of the course of the disease. Clinical symptoms included 3 circumstances :general symptoms, local signs of the nervous system and no obvious symptoms, and may be classified into 3 types :temporal lobes, brain stem, and cerebellum types. In this series of patients, 9.5% had no clinical symptoms. It can be seen that the diagnosis of REP could not depend on its clinical manifestations only. It was suggested that the lesions of the temporal lobes is easy to be seen by CT, but MRI examination is needed for displaying the lesions of the brain stem and cerebellum.