A 24-year-old man, a painter with two years of occupational exposure to paints and thinners under poorly ventilated conditions (8–10 h daily), presented with a three-month history of headache, dizziness, and memory decline, and acute-onset dysarthria and behavioral disturbance occurring one day prior. No evidence of infection, demyelination, or vasculitis was found. Laboratory tests showed mild leukocytosis (10.96×10⁹/L). Brain MR diffusion‑weighted imaging (Fig. 1) showed symmetric hyperintensities in the bilateral cerebral white matter, basal ganglia, and dentate nuclei.
