INTRODUCTION: Acute @entity75 with biphasic @entity410 and late reduced diffusion (AESD) is the most common subtype of infectious pediatric @entity75 in Japan. It is sometimes difficult to make an early diagnosis of AESD; excitotoxicity is postulated to be the pathogenesis based on elevated @entity3264 ( @entity7647 ) and @entity3264 ( @entity367 ) complex (Glx = @entity367 + @entity7647 ) observed on MR spectroscopy. It is uncertain whether @entity7647 or @entity367 contributes to the elevated Glx, or whether MR spectroscopy is useful for an early diagnosis. METHODS: Five Japanese @entity1 with AESD (three @entity1 and two @entity1 , 1  year of age) were enrolled in this study. MR spectroscopy was acquired from the frontal white matter (repetition time (TR) of 5000  ms, echo time (TE) of 30  ms) with a 1.5- or 3.0-T scanner. MR spectroscopy was performed four times for two @entity1 , three times for one @entity1 , and two times for two @entity1 . Quantification of @entity367 and @entity7647 was performed using LCModel. RESULTS: @entity367 was elevated in three of four studies on days 1-4 and became normal or low afterward. @entity7647 was normal in three studies on days 1-2, elevated in all seven studies on days 4-12, and became normal or low afterward. CONCLUSION: These findings suggest that MR spectroscopy may be useful for an early diagnosis. Acute @entity367 elevation changes to subacute @entity7647 elevation, suggesting that a disrupted @entity367 - @entity7647 cycle may play an important role.

Disrupted XXXX - @entity3264 cycle in acute @entity75 with biphasic @entity410 and late reduced diffusion.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'girls', 'boys'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity3264 :: ('D018698', 'Chemical') :: ['glutamine', 'glutamate'] @entity75 :: ('MESH:D001927', 'Disease') :: ['encephalopathy'] @entity7647 :: ('CHEBI:32668', 'Chemical') :: ['Gln'] @entity367 :: ('CHEBI:18237', 'Chemical') :: ['Glu']
@entity3264 :: (D018698,Chemical) :: ['glutamate']
