Longitudinal magnetic resonance imaging changes in Japanese encephalitis.

Authors:
Yukie Arahata
Yukie Arahata
Asahi General Hospital
Katsunori Fujii
Katsunori Fujii
Chiba University Graduate School of Medicine
Tatsuya Nishimura
Tatsuya Nishimura
The University of Tokyo
Japan
Katsuhiko Kitazawa
Katsuhiko Kitazawa
Asahi General Hospital
Akihito Honda
Akihito Honda
Asahi General Hospital
Japan

Brain Dev 2019 Apr 16. Epub 2019 Apr 16.

Department of Pediatrics, Asahi General Hospital, Chiba, Japan.

Background: Japanese encephalitis is a flavivirus that can cause pandemic encephalitis, and is prevalent in Southeast Asia and Australia. Brain images of patients with Japanese encephalitis are characterized by thalamic lesions, distinct from those seen in viral encephalopathies caused by the herpes simplex virus and West Nile virus.

Aim: Herein, we describe for the first time a time-dependent magnetic resonance imaging pattern in Japanese encephalitis in a 10-month-old Japanese boy.

Case: The patient was a previously healthy 10-month-old Japanese boy, who exhibited acute-onset flaccid tetraplegia and loss of tendon reflexes.

Results: Brain MRI showed characteristic thalamic changes on diffusion weighted images from spotty to uniform and from the left to the right side, associated with low apparent diffusion coefficient maps. These images suggest that the Japanese encephalitis virus may first affect the unilateral thalamus, possibly expanding to the other side, with characteristic patterns changing from spotty to uniform in a manner consistent with the presentation of cytotoxic edema.

Conclusion: This report first showed longitudinal magnetic resonance changes in Japanese encephalitis, which may help in accurate diagnosis and in discrimination from other etiologies.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S03877604183056
Publisher Site
http://dx.doi.org/10.1016/j.braindev.2019.04.005DOI Listing
April 2019
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