Fig. 4

Brain MR DWI sequence of case 4, showed bilateral basal ganglia, thalamus, and white matter adjacent to the posterior horn of the lateral ventricle with symmetrical diffuse high signal, and a low signal was seen in the bilateral thalamic lesions, and hemorrhage was considered. The patient presented with typical features of necrotizing encephalopathy, exhibiting significant consciousness impairment and irregular respiratory rhythm upon admission. Following treatment, the patient was transferred from the ICU, but later experienced cognitive regression and impairment in motor function