has acute effects on the lungs, skin and brain and characteristic long-term
effects on the nervous system, which likely occur through varied mechanisms.
Imaging findings are helpful in arriving at a diagnosis, and suggest
preferential affection of the brainstemand cerebellumin a strikingly symmetric
fashion. Serum bromide levels, if available, may help to confirmthe
diagnosis but a normal level does not exclude the diagnosis.
Supplementary data to this article can be found online at