CASE REPORT Diffusion Tensor Imaging and Fiber Tractography in Parry-Romberg Syndrome

SUMMARY: We report a case of Parry-Romberg syndrome in a 32-year-old woman presenting with intermittent headache and mild sensory disturbance. MR imaging revealed minimal asymmetric atrophy of the right hemisphere with a few nonspecific white matter hyperintensities. Diffusion tensor imaging and fiber tractography, however, demonstrated clear fiber derangement, especially in the sensory tract of the right cerebral white matter. Parry-Romberg syndrome (PRS) is an acquired progressivefacial hemiatrophy of the skin and subcutaneous tissue, and sometimes underlying bony structure, with an occasional involvement of the nervous system1-5 The atrophic process commonly appears during the first and second decades of life and affects mainly the face below the forehead.6 The most common neurologic manifestation is epilepsy; however, there are many other neurologic features, such as migraine, facial pain, and structural brain lesions.1-8 We report a case of a patient with PRS presenting with sensory disturbance and subtle whitematter changes.We con