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A previously well 16-year-old boy developed a rapid-onset hypokinetic syndrome, coupled with a radiological appearance of extensive and highly symmetrical basal ganglia and white matter change. The diagnostic process was challenging and we systematically considered potential causes. After excluding common causes of this clinico-radiological picture, we considered common disorders with this unusual radiological picture and vice versa, before finally concluding that this was a rare presentation of a rare disease. We considered the broad categories of: metabolic; toxic; infective; inflammatory, postinfective and immune-mediated; neoplastic; paraneoplastic and heredodegenerative. Long-term follow-up gave insight into the nature of the insult, confirming the monophasic course. During recovery, and following presumed secondary aberrant reinnervation, his disorder evolved from predominantly hypokinetic to hyperkinetic. Here, we explore the process of finding a 'best-fit' diagnosis: in this case, acute necrotising encephalopathy. [ABSTRACT FROM AUTHOR]

This is a review of the use of neuroimaging in epilepsy outlining the imaging strategy for new onset seizures and also those with intractable focal seizures being investigated as potential epilepsy surgery candidates. The review describes the radiological features of conditions which may be encountered in each clinical context, together with advice on the optimum imaging protocols to detect epileptogenic lesions. The review also presents the role of imaging in presurgical planning, the demonstration of eloquent function, grid placement and postoperative assessment. [ABSTRACT FROM AUTHOR]

Over 800 000 people in the UK are demented. Alzheimer's disease, dementia with Lewy bodies, vascular dementia and fronttemporal lobar degeneration account for the majority. Although detailed clinical assessment forms the basis of evaluating a patient with cognitive impairment, structural and functional imaging techniques are increasingly being used. Neuroimaging can identify changes to supplement the clinical diagnosis and help to distinguish dementia subtypes. This may be important for treatment, prognosis and care planning. Furthermore, early changes on structural and functional imaging may have a role in preclinical detection, perhaps allowing people to start any treatments early. In this review, we explain the tools available to the neuroradiologist and examine the implications of imaging findings in assessing patients with cognitive impairment or dementia. [ABSTRACT FROM AUTHOR]