Face of the giant panda sign

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|image = Face of the giant panda sign in Wilson's disease.png

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|caption = Axial T2-weighted MRI of the brain at the level of the midbrain showing the characteristic ‘face of the giant panda’ sign, with normal red nuclei and substantia nigra (pars reticulata) against a background of hyperintensity in the tegmentum, as well as hypointensity of the superior colliculi

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|complications = choreoathetosis

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|differential = Wilson's disease, Wernicke's encephalopathy, Leigh syndrome, acute disseminated encephalomyelitis, toxic leukoencephalopathy, rabies

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|medication = penicillamine, thiamine, corticosteroids

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The face of the giant panda sign, panda sign of the midbrain or double-panda sign is a characteristic "panda's face" appearance in magnetic resonance imaging (MRI) images of people with Wilson's disease. Along with Kayser–Fleischer rings, the sign is helpful in diagnosis.{{cite journal |pmid=11146611 |url=http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2000;volume=48;issue=4;spage=395;epage=6;aulast=Kuruvilla |year=2000 |last1=Kuruvilla |first1=A. |title='Face of the giant panda' sign in Wilson's disease: Revisited |journal=Neurology India |volume=48 |issue=4 |pages=395–6 |last2=Joseph |first2=S. }}

While the sign is most common in Wilson's disease, it has been rarely reported in acute disseminated encephalomyelitis,{{cite journal |pmid=32643704 |year=2020 |last1=Nagabushana |first1=D. |last2=Kumar |first2=SP. |last3=Nagaraj |first3=K. |title=Giant Panda in ADEM |journal=Neurol India |volume=68 |issue=3 |pages=720–1|doi=10.4103/0028-3886.289008|s2cid=220437811 |doi-access=free }} rabies encephalopathy,{{cite journal |pmid=27011645 |year=2016 |last1=Jassi |first1=P. |last2=Attri |first2=A. |last3=Dhawan |first3=R. |last4=Kakkar |first4=C. |last5=Saggar |first5=K. |title=MR imaging in rabies encephalopathy: A rare entity |journal=Ann Indian Acad Journal |volume=19 |issue=1 |pages=125–8|doi=10.4103/0972-2327.167712 |pmc=4782530 |doi-access=free }} toxic leukoencephalopathy{{cite journal |pmid=25987753 |year=2015 |last1=Bimbato |first1=EM. |last2=Carvalho |first2=AG. |last3=Reis |first3=F. |title=Toxic and metabolic encephalopathies: iconographic essay |journal=Radiol Bras. |volume=48 |issue=2 |pages=121–5|doi=10.1590/0100-3984.2013.1923 |pmc=4433303 }} and Leigh syndrome.{{cite journal |pmid=23599247 |url=https://pubmed.ncbi.nlm.nih.gov/23599247/ |year=2014 |last1=Sonam |first1=K. |last2=Bindu |first2=P. |last3=Gayathri |first3=N. |last4=Khan |first4=N. |last5=Govindaraju |first5=C. |last6=Arvinda |first6=H. |last7=Nagappa |first7=M. |last8=Sinha |first8=S. |last9=Thangaraj |first9=K. |last10=Taly |first10=A.

|title=The "double panda" sign in Leigh disease |journal=J Child Neurol |volume=29 |issue=7 |pages=980–2 |doi=10.1177/0883073813484968 |s2cid=5969381 }}