Fig. 1

Brain magnetic resonance imaging (MRI) and electroencephalography. a, b, c MRI of the brain of patient #1 showing asymmetrical involvement of the cortex and subcortical white matter with high-intensity signals evident on axial T2-weighted. a T2-fluid attenuation inversion recovery (T2-FLAIR). b Apparent diffusion coefficient (ADC). c Scans. Similar MRI findings were obtained in five other patients with cyclosporine A-related neurotoxicity (patients #2, #3, #4, #5 and #7). d and e. Axial FLAIR MRI of the brain of patient #6 (obtained 3 days after the onset of symptoms) showing hyperintense signals in the periventricular white matter (white arrow in d and e) as well as the thalamus (blue arrow in d) and hippocampus (blue arrow in e). f Axial T1-weighted MRI of the brain of patient #4 obtained 3 days after the onset of symptoms. This patient had cerebral hemorrhage associated with posterior reversible encephalopathy syndrome that manifested as a parenchymal hematoma and small hemorrhages < 5 mm in size. The white arrow indicates a microbleed in the occipital lobe. g, h and i. Follow-up MRI of the brain of patient #2. g Patchy shadows with high signal intensity were observed in the lateral periventricular white matter 3 days after the onset of symptoms. h Hyperintense patchy shadowing in the lateral periventricular white matter was increased at 1 month after onset, despite an improvement in clinical symptoms at this time. i Patchy shadowing was less evident at 6 months after symptom onset. j and k. Electroencephalography and MRI findings in patient #3. MRI showed local cortical atrophy in the left parietal and occipital lobes, and the electroencephalogram demonstrated a spike rhythm originating from the same region of the brain